Published ahead of print on February 5, 2004, doi:10.1164/rccm.200309-1305OC
American Journal of Respiratory and Critical Care Medicine Vol 169. pp. 950-956, (2004)
© 2004 American Thoracic Society
Twenty-four–hour Ambulatory Blood Pressure in Children with Sleep-disordered Breathing
Raouf S. Amin,
John L. Carroll,
Jenny L. Jeffries,
Charles Grone,
Judy A. Bean,
Barbara Chini,
Ronald Bokulic and
Stephen R. Daniels
Sleep Disorder Center, Divisions of Pulmonary Medicine, Epidemiology and Biostatistics, and Cardiology, The University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; and Department of Pediatric Pulmonary Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas
Correspondence and requests for reprints should be addressed to Raouf S. Amin, M.D., Division of Pulmonary Medicine, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH 45229. E-mail: aminr0{at}chmcc.org
Obstructive sleep apnea causes intermittent elevation of systemic blood pressure (BP) during sleep. To determine whether obstructive apnea in children has a tonic effect on diurnal BP, 24-hour ambulatory blood pressure was obtained from 60 children with mean age of 10.8 ± 3.5 years. Thirty-nine children had obstructive apnea and 21 had primary snoring. Children with obstructive apnea had significantly greater mean BP variability during wakefulness and sleep, a higher night-to-day systolic BP, and a smaller nocturnal dipping of mean BP. Variability of mean arterial pressure during wakefulness was predicted by the desaturation, body mass, and arousal indices, whereas variability during sleep was predicted by apnea–hypopnea and body mass indices. Nocturnal BP dipping was predicted by the desaturation index. There were no significant differences in systolic, diastolic, or mean arterial BP during sleep between the groups. Diastolic BP during wakefulness was significantly different between the groups and correlated negatively with apnea–hypopnea index. We conclude that obstructive apnea in children is associated with 24-hour BP dysregulation and that, independent of obesity, the frequency of obstructive apnea, oxygen desaturation, and arousal contributes to abnormal BP control.
Key Words: obstructive apnea • ambulatory blood pressure • child • cardiovascular
This article has been cited by other articles:
|
|
|
|
 
B. McGinley, A. Halbower, A. R. Schwartz, P. L. Smith, S. P. Patil, and H. Schneider
Effect of a High-Flow Open Nasal Cannula System on Obstructive Sleep Apnea in Children
Pediatrics,
July 1, 2009;
124(1):
179 - 188.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
E. O. Bixler, A. N. Vgontzas, H.-M. Lin, D. Liao, S. Calhoun, F. Fedok, V. Vlasic, and G. Graff
Blood Pressure Associated With Sleep-Disordered Breathing in a Population Sample of Children
Hypertension,
November 1, 2008;
52(5):
841 - 846.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
V. K. Somers, D. P. White, R. Amin, W. T. Abraham, F. Costa, A. Culebras, S. Daniels, J. S. Floras, C. E. Hunt, L. J. Olson, et al.
Sleep Apnea and Cardiovascular Disease: An American Heart Association/American College of Cardiology Foundation Scientific Statement From the American Heart Association Council for High Blood Pressure Research Professional Education Committee, Council on Clinical Cardiology, Stroke Council, and Council on Cardiovascular Nursing In Collaboration With the National Heart, Lung, and Blood Institute National Center on Sleep Disorders Research (National Institutes of Health)
Circulation,
September 2, 2008;
118(10):
1080 - 1111.
[Full Text]
[PDF]
|
|
|
|
|
|
|
A M Li, C T Au, R Y T Sung, C Ho, P C Ng, T F Fok, and Y K Wing
Ambulatory blood pressure in children with obstructive sleep apnoea: a community based study
Thorax,
September 1, 2008;
63(9):
803 - 809.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
E. Urbina, B. Alpert, J. Flynn, L. Hayman, G. A. Harshfield, M. Jacobson, L. Mahoney, B. McCrindle, M. Mietus-Snyder, J. Steinberger, et al.
Ambulatory Blood Pressure Monitoring in Children and Adolescents: Recommendations for Standard Assessment: A Scientific Statement From the American Heart Association Atherosclerosis, Hypertension, and Obesity in Youth Committee of the Council on Cardiovascular Disease in the Young and the Council for High Blood Pressure Research
Hypertension,
September 1, 2008;
52(3):
433 - 451.
[Full Text]
[PDF]
|
|
|
|
|
|
|
V. K. Somers, D. P. White, R. Amin, W. T. Abraham, F. Costa, A. Culebras, S. Daniels, J. S. Floras, C. E. Hunt, L. J. Olson, et al.
Sleep Apnea and Cardiovascular Disease: An American Heart Association/American College of Cardiology Foundation Scientific Statement From the American Heart Association Council for High Blood Pressure Research Professional Education Committee, Council on Clinical Cardiology, Stroke Council, and Council on Cardiovascular Nursing In Collaboration With the National Heart, Lung, and Blood Institute National Center on Sleep Disorders Research (National Institutes of Health)
J. Am. Coll. Cardiol.,
August 19, 2008;
52(8):
686 - 717.
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. M. Hogan, C. M. Hill, D. Harrison, and F. J. Kirkham
Cerebral Blood Flow Velocity and Cognition in Children Before and After Adenotonsillectomy
Pediatrics,
July 1, 2008;
122(1):
75 - 82.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
L. Kheirandish-Gozal and D. Gozal
Intranasal Budesonide Treatment for Children With Mild Obstructive Sleep Apnea Syndrome
Pediatrics,
July 1, 2008;
122(1):
e149 - e155.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
D. Gozal, O. S. Capdevila, and L. Kheirandish-Gozal
Metabolic Alterations and Systemic Inflammation in Obstructive Sleep Apnea among Nonobese and Obese Prepubertal Children
Am. J. Respir. Crit. Care Med.,
May 15, 2008;
177(10):
1142 - 1149.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
S. Kapa, F. H. Sert Kuniyoshi, and V. K. Somers
Sleep Apnea and Hypertension: Interactions and Implications for Management
Hypertension,
March 1, 2008;
51(3):
605 - 608.
[Full Text]
[PDF]
|
|
|
|
|
|
|
H. Muzumdar and R. Arens
Diagnostic Issues in Pediatric Obstructive Sleep Apnea
Proceedings of the ATS,
February 15, 2008;
5(2):
263 - 273.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
O. S. Capdevila, L. Kheirandish-Gozal, E. Dayyat, and D. Gozal
Pediatric Obstructive Sleep Apnea: Complications, Management, and Long-term Outcomes
Proceedings of the ATS,
February 15, 2008;
5(2):
274 - 282.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
R. Amin, V. K. Somers, K. McConnell, P. Willging, C. Myer, M. Sherman, G. McPhail, A. Morgenthal, M. Fenchel, J. Bean, et al.
Activity-Adjusted 24-Hour Ambulatory Blood Pressure and Cardiac Remodeling in Children with Sleep Disordered Breathing
Hypertension,
January 1, 2008;
51(1):
84 - 91.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
S. Redline and C. Ievers-Landis
Blood Pressure and OSAS in Children
Am. J. Respir. Crit. Care Med.,
November 15, 2007;
176(10):
1055 - 1055.
[Full Text]
[PDF]
|
|
|
|
|
|
|
D. Gozal, L. Kheirandish-Gozal, L. D. Serpero, O. Sans Capdevila, and E. Dayyat
Obstructive Sleep Apnea and Endothelial Function in School-Aged Nonobese Children: Effect of Adenotonsillectomy
Circulation,
November 13, 2007;
116(20):
2307 - 2314.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
D. Gozal, O. S. Capdevila, L. Kheirandish-Gozal, and V. M. Crabtree
APOE {varepsilon}4 allele, cognitive dysfunction, and obstructive sleep apnea in children
Neurology,
July 17, 2007;
69(3):
243 - 249.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
D. Gozal, V. M. Crabtree, O. Sans Capdevila, L. A. Witcher, and L. Kheirandish-Gozal
C-reactive Protein, Obstructive Sleep Apnea, and Cognitive Dysfunction in School-aged Children
Am. J. Respir. Crit. Care Med.,
July 15, 2007;
176(2):
188 - 193.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
C. E. Ievers-Landis and S. Redline
Pediatric Sleep Apnea: Implications of the Epidemic of Childhood Overweight
Am. J. Respir. Crit. Care Med.,
March 1, 2007;
175(5):
436 - 441.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
S. L Verhulst, N. Schrauwen, D. Haentjens, B. Suys, R. P Rooman, L. Van Gaal, W. A De Backer, and K. N Desager
Sleep-disordered breathing in overweight and obese children and adolescents: prevalence, characteristics and the role of fat distribution
Arch. Dis. Child.,
March 1, 2007;
92(3):
205 - 208.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
E. Zintzaras and A. G. Kaditis
Sleep-Disordered Breathing and Blood Pressure in Children: A Meta-analysis
Arch Pediatr Adolesc Med,
February 1, 2007;
161(2):
172 - 178.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
W. T. McNicholas, M. R. Bonsignore, and the Management Committee of EU COST ACTION B26
Sleep apnoea as an independent risk factor for cardiovascular disease: current evidence, basic mechanisms and research priorities
Eur. Respir. J.,
January 1, 2007;
29(1):
156 - 178.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
A M Li, E Hung, T Tsang, J Yin, H K So, E Wong, T F Fok, and P C Ng
Induced sputum inflammatory measures correlate with disease severity in children with obstructive sleep apnoea
Thorax,
January 1, 2007;
62(1):
75 - 79.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. G. Kaditis, E. I. Alexopoulos, F. Hatzi, E. Kostadima, M. Kiaffas, E. Zakynthinos, and K. Gourgoulianis
Overnight change in brain natriuretic Peptide levels in children with sleep-disordered breathing.
Chest,
November 1, 2006;
130(5):
1377 - 1384.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
L. C.K. Leung, D. K. Ng, M. W. Lau, C.-h. Chan, K.-l. Kwok, P.-y. Chow, and J. M.Y. Cheung
Twenty-Four-Hour Ambulatory BP in Snoring Children With Obstructive Sleep Apnea Syndrome.
Chest,
October 1, 2006;
130(4):
1009 - 1017.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
C. M. Hill, A. M. Hogan, N. Onugha, D. Harrison, S. Cooper, V. J. McGrigor, A. Datta, and F. J. Kirkham
Increased Cerebral Blood Flow Velocity in Children With Mild Sleep-Disordered Breathing: A Possible Association With Abnormal Neuropsychological Function
Pediatrics,
October 1, 2006;
118(4):
e1100 - e1108.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. M. Statham, R. G. Elluru, R. Buncher, and M. Kalra
Adenotonsillectomy for obstructive sleep apnea syndrome in young children: prevalence of pulmonary complications.
Arch Otolaryngol Head Neck Surg,
May 1, 2006;
132(5):
476 - 480.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
L. M. O'Brien, L. D. Serpero, R. Tauman, and D. Gozal
Plasma adhesion molecules in children with sleep-disordered breathing.
Chest,
April 1, 2006;
129(4):
947 - 953.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. N. Roemmich, J. E. Barkley, L. D'Andrea, M. Nikova, A. D. Rogol, M. A. Carskadon, and P. M. Suratt
Increases in Overweight After Adenotonsillectomy in Overweight Children With Obstructive Sleep-Disordered Breathing Are Associated With Decreases in Motor Activity and Hyperactivity
Pediatrics,
February 1, 2006;
117(2):
e200 - e208.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
G. Tino
Clinical Year in Review III: Sleep-disordered Breathing, Interstitial Lung Disease, Lung Transplantation, and Pediatric Pulmonary Disease
Proceedings of the ATS,
November 1, 2005;
2(4):
251 - 254.
[Full Text]
[PDF]
|
|
|
|
|
|
|
C. Guilleminault, J. H. Lee, and A. Chan
Pediatric Obstructive Sleep Apnea Syndrome
Arch Pediatr Adolesc Med,
August 1, 2005;
159(8):
775 - 785.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
R. Tauman, L. M. O'Brien, A. Ivanenko, and D. Gozal
Obesity Rather Than Severity of Sleep-Disordered Breathing as the Major Determinant of Insulin Resistance and Altered Lipidemia in Snoring Children
Pediatrics,
July 1, 2005;
116(1):
e66 - e73.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
E. K. Larkin, C. L. Rosen, H. L. Kirchner, A. Storfer-Isser, J. L. Emancipator, N. L. Johnson, A. M. V. Zambito, R. P. Tracy, N. S. Jenny, and S. Redline
Variation of C-Reactive Protein Levels in Adolescents: Association With Sleep-Disordered Breathing and Sleep Duration
Circulation,
April 19, 2005;
111(15):
1978 - 1984.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
T. D. Bradley, Y. E. Miller, F. J. Martinez, D. C. Angus, W. MacNee, and E. Abraham
Interstitial Lung Disease, Lung Cancer, Lung Transplantation, Pulmonary Vascular Disorders, and Sleep-disordered Breathing in AJRCCM in 2004
Am. J. Respir. Crit. Care Med.,
April 1, 2005;
171(7):
675 - 685.
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. Kelly and C. L. Marcus
Childhood Obesity, Inflammation, and Apnea: What Is the Future for Our Children?
Am. J. Respir. Crit. Care Med.,
February 1, 2005;
171(3):
202 - 203.
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. G. Kaditis, E. I. Alexopoulos, E. Kalampouka, E. Kostadima, A. Germenis, E. Zintzaras, and K. Gourgoulianis
Morning Levels of C-Reactive Protein in Children with Obstructive Sleep-disordered Breathing
Am. J. Respir. Crit. Care Med.,
February 1, 2005;
171(3):
282 - 286.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
A.G. Kaditis, E.I. Alexopoulos, E. Kalampouka, E. Kostadima, N. Angelopoulos, A. Germenis, E. Zintzaras, and K. Gourgoulianis
Morning levels of fibrinogen in children with sleep-disordered breathing
Eur. Respir. J.,
November 1, 2004;
24(5):
790 - 797.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
D. K. Ng, L. C. Leung, C.-H. Chan, R. Amin, J. Bean, B. Chini, J. L. Carroll, and S. Daniels
Blood Pressure in Children with Sleep-disordered Breathing
Am. J. Respir. Crit. Care Med.,
August 15, 2004;
170(4):
467 - 467.
[Full Text]
[PDF]
|
|
|
Copyright © 2004 American Thoracic Society
|
|
|
