0867 Developmental Trajectories of Childhood Sleep Disordered Breathing Associated with Endothelial Function and Atherosclerosis in Young Adulthood

Abstract Introduction There are no lifespan epidemiological studies describing the developmental trajectories of sleep disordered breathing (SDB) in children as they grow into adults. No studies have examined how the developmental trajectories of childhood SDB impact cardiovascular health in young adulthood. Methods A total of 698 participants from the Penn State Child Cohort, a randomly-selected population-based sample (52% female, 24% racial/ethnic minority), underwent in-lab polysomnography in childhood (5-12y), adolescence (12-19y), and young adulthood (20-32y) with a median follow-up time of 15y. Growth mixture models were used to classify the 698 individual trajectories of apnea/hypopnea index (AHI) into latent age-related classes (trajectories), while including sex, race/ethnicity, body mass index, and treatment (adenotonsillectomy or positive airway pressure therapy) as risk factors. Thereafter, we examined the association of the identified AHI trajectories with flow-mediated dilation (FMD) and carotid intima-media thickness (CIMT) in young adulthood, as measured by Doppler ultrasound. Results AHI showed four age-related trajectories: one with stable AHI from age 5 through 30 (85.8% of subjects), one with higher AHI at ages 5-10 that remained elevated through age 30 (7.5% of subjects), one with AHI that increased at age 13, peaked at age 16, and decreased after age 20 (3.4%) and one with AHI that increased at age 16 and continued to increase through age 30 (3.3% of subjects). Trajectories with highest AHI at critical developmental periods showed lower FMD (p<.045) and greater left and right CIMT (p<.001) at ages 20-32. Conclusion SDB shows well-delineated growth curves and developmental trajectories. Adolescent-onset SDB has the greatest impact on atherosclerotic cardiovascular health later in young adulthood. Support (if any) R01HL136587