A 4-year prospective follow-up study of childhood OSA and its association with BP

Chest. 2014 Jun;145(6):1255-1263. doi: 10.1378/chest.13-1333.


Background: Childhood OSA is a prevalent condition associated with raised BP as documented in cross-sectional studies. This study aimed to determine whether baseline or change in OSA severity was associated with ambulatory BP at 4-year follow-up.

Methods: Children who participated in our previous OSA prevalence research were invited to undergo a repeat overnight sleep study and 24-h ambulatory BP monitoring in this 4-year follow-up study. BP parameters of subjects with differing baseline OSA severity, that is, obstructive apnea-hypopnea index (OAHI) < 1/h, 1 to 5/h, and > 5/h, were compared. Overweight and normal-weight children were analyzed separately.

Results: One hundred eighty-five of 306 subjects (60%) were included in the analysis, of whom 58 were overweight at baseline. Linear increasing trends of wake systolic BP (SBP), wake diastolic BP (DBP), and sleep SBP z scores at follow-up were found across groups of increasing baseline OSA severity in the normal weight but not in the overweight subgroup. After adjusting for BMI z score, baseline OAHI was independently associated with all BP z scores at follow-up but not associated with changes in BP z scores across 4 years. On the other hand, change in OAHI was independently associated with sleep SBP and DBP z scores at follow-up and with changes in sleep SBP and DBP z scores across 4 years.

Conclusions: This study provides longitudinal data as additional proof that childhood OSA is associated with elevated BP independent of obesity.

MeSH terms

  • Adolescent
  • Blood Pressure / physiology*
  • Blood Pressure Monitoring, Ambulatory
  • Child
  • Circadian Rhythm / physiology
  • Comorbidity
  • Female
  • Follow-Up Studies
  • Hong Kong
  • Humans
  • Hypertension / physiopathology*
  • Longitudinal Studies
  • Male
  • Obesity / physiopathology
  • Polysomnography
  • Prospective Studies
  • Severity of Illness Index
  • Sleep Apnea, Obstructive / physiopathology*