Ambulatory blood pressure in children with obstructive sleep apnoea: a community based study

Li, A. M.; Au, C. T.; Sung, R. Y. I.; Ho, C.; Ng, P. C.; Fok, I. F.; Wing, Y. K.
September 2008
Thorax;Sep2008, Vol. 63 Issue 9, p803
Academic Journal
Background: Childhood obstructive sleep apnoea (USA) is increasingly being recognised. Its effects on blood pressure (BP) elevation and hypertension are still controversial. Objective: To evaluate the association between USA and ambulatory BP in children. Methods: Children aged 6-13 years from randomly selected schools were invited to undergo overnight sleep study and ambulatory BP monitoring after completing a validated USA questionnaire. USA was diagnosed if the obstructive apnoea-hypopnoea index (AHI) was >1, and normal controls had AHI <1 and snoring <3 nights per week. Children with USA were subdivided into a mild group (AHI 1-5) and moderate to severe group (AHI >5). Results: 306 subjects had valid sleep and daytime BP data. Children with USA had significantly higher BP than normal healthy children during both sleep and wakefulness. BP levels increased with the severity of USA, and children with moderate to severe disease (AHI >5) were at significantly higher risk for nocturnal systolic (OR 3.9 (95% Cl 1.4 to 10.5)) and diastolic (OR 3.3 (95% Cl 1.4 to 8.1)) hypertension. Multiple linear regression revealed a significant association between oxygen desaturation index and AHI with daytime and nocturnal BP, respectively, independent of obesity. Conclusions: USA was associated with elevated day-time and nocturnal BP, and is an independent predictor of nocturnal hypertension. This has important clinical implications as childhood elevated BP predicts future cardiovascular risks. Future studies should examine the effect of therapy for USA on changes in BP.


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