Impaired blood pressure control in children with obstructive sleep apnea
Autor: | Scott A. Sands, Stephanie Yiallourou, Margot J Davey, Rosemary S.C. Horne, Lisa M. Walter, Gillian M. Nixon, John Trinder, Anna Vlahandonis, Candice Johnson, Adrian M. Walker |
---|---|
Rok vydání: | 2013 |
Předmět: |
Male
Blood pressure control medicine.medical_specialty Elevated bp Polysomnography Blood Pressure Baroreflex Autonomic Nervous System Severity of Illness Index Heart Rate Internal medicine Humans Medicine Spectral analysis Child Sleep Apnea Obstructive medicine.diagnostic_test business.industry Snoring Sleep apnea General Medicine medicine.disease nervous system diseases respiratory tract diseases Obstructive sleep apnea Blood pressure Anesthesia Hypertension Cardiology Female Sleep Stages business |
Zdroj: | Sleep Medicine. 14:858-866 |
ISSN: | 1389-9457 |
Popis: | Background: Obstructive sleep apnea (OSA) in adults has been associated with hypertension, low baroreflex sensitivity (BRS), a delayed heart rate response to changing blood pressure (heart period delay [HPD]), and increased blood pressure variability (BPV). Poor BRS may contribute to hypertension by impairing the control of blood pressure (BP), with increased BPV and HPD. Although children with OSA have elevated BP, there are scant data on BRS, BPV, or HPD in this group. Methods: 105 children ages 7–12 years referred for assessment of OSA and 36 nonsnoring controls were studied. Overnight polysomnography (PSG) was performed with continuous BP monitoring. Subjects were assigned to groups according to their obstructive apnea–hypopnea index (OAHI): primary snoring (PS) (OAHI 61 event/h), mild OSA (OAHI > 1–65 events/h) and moderate/severe (MS) OSA (OAHI > 5 events/h). BRS and HPD were calculated using cross spectral analysis and BPV using power spectral analysis. Results: Subjects with OSA had significantly lower BRS (p < .05 for both) and a longer HPD (PS and MS OSA, p < .01; mild OSA, p < .05) response to spontaneous BP changes compared with controls. In all frequencies of BPV, the MS group had higher power compared with the control and PS groups (low frequency [LF], p < .05; high frequency [HF], p < .001). Conclusions: Our study demonstrates reduced BRS, longer HPD, and increased BPV in subjects with OSA compared to controls. This finding suggests that children with OSA have altered baroreflex function. Longitudinal studies are required to ascertain if this dampening of the normal baroreflex response can be reversed with treatment. |
Databáze: | OpenAIRE |
Externí odkaz: |