Blood Pressure in Children with Obstructive Sleep Apnea

TLDR

Hypertension is a common complication of obstructive sleep apnea in adults, yet it has not been systematically studied in children with the syndrome. The study aimed to measure blood pressure during polysomnography in 41 children with OSAS compared to 26 children with primary snoring. Systolic and diastolic blood pressure were recorded every 15 minutes using an automated arm cuff during sleep studies. Children with OSAS exhibited significantly higher diastolic blood pressure than those with primary snoring, with no systolic difference; blood pressure was predicted by apnea index, BMI, and age, was lower during sleep than wakefulness, and the study concludes that childhood OSAS is associated with systemic diastolic hypertension.

Abstract

Hypertension is a common complication of obstructive sleep apnea in adults. However, hypertension has not been studied systematically in children with the obstructive sleep apnea syndrome (OSAS). We therefore measured blood pressure (BP) during polysomnography in 41 children with OSAS, compared to 26 children with primary snoring (PS). Systolic and diastolic BP were measured every 15 min via an appropriately sized arm cuff, using an automated system. This was tolerated by the children without inducing arousals from sleep. Children with OSAS had a significantly higher diastolic BP than those with PS (p < 0.001 for sleep and p < 0.005 for wakefulness). There was no significant difference in systolic BP between the two groups. Multiple linear regression showed that blood pressure could be predicted by apnea index, body mass index, and age. Blood pressure during sleep was lower than during wakefulness (p < 0.001 for diastole and p < 0.01 for systole), but did not differ significantly between rapid eye movement (REM) and non–REM sleep. We conclude that childhood OSAS is associated with systemic diastolic hypertension.