Pediatric obstructive sleep apnea (OSA) correlates with elevated levels of nocturnal blood pressure (BP)

The aim was to explore the correlation between OSA severity (apnea-hypopnea index-AHI) and 24h ambulatory BP monitoring in children. Prospective study including 284 children (4-18 yrs) with suspected OSA. Polysomnography was performed to assess OSA severity establishing 4 groups: I) No OSA: AHI<3/h; II) Mild OSA: <5/h; III) Moderate OSA: <10/h; IV) Severe OSA: ≥10/h. Mean BP, systolic BP (SBP), diastolic BP (DBP), global, daytime and nighttime and non-dipper pattern (NDP) were collected. The relationship of BP and OSA groups was analyzed. The frequency of NDP was investigated through a trend analysis and by means of multivariable logistic regression models. The median age was 6 yr (59% men). Group distribution was: I) 20.5%, II) 19.8%, III) 33% and IV)26.7%. Statistically significant trends were observed in the following variables according to the OSA groups: 24h BP (p=0.045), nocturnal mean BP (p=0.003), SBP (p=0.008) and DBP (p=0.006). No differences were observed in daytime BP. Most patients with high BP (87.5%) and all patients with hypertension diagnosis were found in the III-IV groups. Significant trends were observed depending on the AHI for the decrease in 24h mean BP (p=0.019) and for NDP presence (p=0.007) (Table 1). Multivariable analysis of NDP showed significant differences in age, OR=0.86 [0.77-0.97] and in severe OSA vs. non-OSA, OR=2.44 [1.13-5.28]. A clear relationship exists between pediatric OSA and increased BP, with a notable impact on nocturnal BP. They more frequently exhibit a NDP and experience a diminished in 24h mean BP directly correlated with OSA severity. Additionally, the NDP may pose a higher risk of occurrence in younger patients with elevated AHI.