Elsevier

The Journal of Pediatrics

Volume 195, April 2018, Pages 102-107.e1
The Journal of Pediatrics

Original Articles
Systolic Blood Pressure Elevation in Children with Obstructive Sleep Apnea Is Improved with Positive Airway Pressure Use

https://doi.org/10.1016/j.jpeds.2017.11.043Get rights and content

Introduction

To evaluate the effect of continuous positive airway pressure (CPAP) treatment on blood pressure (BP) in children with obstructive sleep apnea (OSA).

Study design

Retrospective chart review of children aged 7-17 referred to Benioff Children's Hospital Oakland for the evaluation of snoring. Data collected included age, body mass index (BMI), BP, heart rate, apnea-hypopnea index, and oxygen saturation nadir. Children were divided into 3 groups: snorers, untreated OSA, and OSA treated with CPAP. Seventy-five children were identified, 25 in each group.

Results

There was no difference in age or apnea-hypopnea index among the groups. The CPAP group had higher BMI than the snorers and untreated OSA groups. Systolic BP was higher in the 2 OSA groups compared with the snorers. After CPAP treatment, systolic BP decreased. The BP decrease was significantly greater in patients with higher BMI at baseline. There was no significant change in diastolic BP in the 3 groups.

Conclusion

Children with OSA have higher systolic BP than habitual snorers. Treatment with CPAP in children with OSA for 6 months reduced their systolic BP despite a small increase in their BMI.

Section snippets

Methods

Our observational study consists of a retrospective chart review of children aged 7-17 years who were referred to the Benioff Children's Hospital Oakland sleep clinic for evaluation of snoring between February 2016 and June 2017. Inclusion criteria included a completed polysomnography (PSG) and office visits: the “initial visit” was either the first consult or CPAP initiation visit and a follow-up visit was done at approximately 6 months. Exclusion criteria included a known history of

Results

Seventy-five children were included, 25 children in each group. Fifty-seven percent of the children were male (43/75). By race/ethnicity, 20% were white, 29% were black, 44% were Hispanic, and 7% were of another ethnic background. Only 20% of children had undergone adenotonsillectomy (AT). The age and ethnicity of the children in the 3 subgroups did not differ (Table I). More males than females were in the 2 OSA groups (P < .02; Table I). More than one-third of the children treated with CPAP

Discussion

Our study shows that children with OSA have higher systolic BP than snorers; failure to treat OSA in children may result in an increased BP and treatment with CPAP decreases the systolic BP to the level of habitual snorers, despite an increase in BMI. This finding suggests that early treatment of children with OSA is effective in reducing BP and, possibly, other cardiovascular complications. Studies have shown that children with OSA often wait 50-141 days for nocturnal PSG and 93-222 days for

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    The authors declare no conflicts of interest.

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