Blood Pressure Associated With Sleep-Disordered Breathing in a Population Sample of Children
Open Access
- 1 November 2008
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in Hypertension
- Vol. 52 (5), 841-846
- https://doi.org/10.1161/hypertensionaha.108.116756
Abstract
The current criteria for sleep-disordered breathing (SDB) in children are not based on a clinically relevant outcome. The purpose of this study was to assess the association of blood pressure with SDB in a random sample of the local elementary school children (kindergarten through grade 5) using a 2-phased strategy. During phase 1, a brief questionnaire was completed for all of the children (N=5740) with a response rate of 78.5%. During phase 2, 700 randomly selected children from phase 1 with a response rate of 70.0% were assessed with a full polysomnograph and a history/physical, including an ECG; ear, nose, and throat; and pulmonary evaluation. We observed a significantly elevated systolic blood pressure associated with the apnea hypopnea index (AHI): AHI ≥1 (2.9 mm Hg); AHI ≥3 (7.1 mm Hg); and AHI ≥5 (12.9 mm Hg). The SDB and blood pressure association remained significant after adjusting for age, sex, race, body mass index percentile or waist circumference, sleep efficiency, percentage of rapid eye movement sleep, and snoring. In addition, older age, body mass index percentile, waist circumference, and snoring were significantly associated with blood pressure, independent of SDB. Based on these findings, our study suggests that SDB is significantly associated with higher levels of systolic blood pressure in children aged 5 to 12 years even after adjusting for the various confounding factors. Clinically, the data support the threshold of AHI ≥5 for the initiation of treatment for SDB. Additional research is indicated to assess the efficacy of SDB treatment on reducing blood pressure.Keywords
This publication has 29 references indexed in Scilit:
- Childhood sleep-disordered breathing and its implications for cardiac and vascular diseases.Journal of Paediatrics and Child Health, 2005
- Sleep apnea is a manifestation of the metabolic syndromeSleep Medicine Reviews, 2005
- Abnormal Blood Pressure in Prepubertal Children with Sleep-Disordered BreathingPediatric Research, 2004
- Echocardiographic parameters in adolescents with sleep-related breathing disordersPediatric Pulmonology, 2003
- Blood pressure in sleep disordered breathingArchives of Disease in Childhood, 2003
- Proposed supplements and amendments to ‘A Manual of Standardized Terminology, Techniques and Scoring System for Sleep Stages of Human Subjects’, the Rechtschaffen & Kales (1968) standardPsychiatry and Clinical Neurosciences, 2001
- Blood Pressure in Children with Obstructive Sleep ApneaAmerican Journal of Respiratory and Critical Care Medicine, 1998
- Effect of Lean Body Mass, Fat Mass, Blood Pressure, and Sexual Maturation on Left Ventricular Mass in Children and AdolescentsCirculation, 1995
- Snoring, sleep disturbance, and behaviour in 4-5 year olds.Archives of Disease in Childhood, 1993
- Blood pressure and echocardiographic measures in children: the Bogalusa Heart Study.Circulation, 1987