Childhood sleep-disordered breathing and its implications for cardiac and vascular diseases.
OBJECTIVE
To systematically evaluate the recent literature regarding the relationship between childhood sleep-disordered breathing (SDB)/obstructive sleep apnoea (OSA) and cardiovascular diseases in children.


METHODS
The literature about SDB/OSA and blood pressure, sympathetic activation, arterial distensibility, ventricular hypertrophy and insulin resistance were studied. Meta-analysis of risk of hypertension and high apnoea-hyponoea index were performed to calculate the combined odds ratio and it is equal to 2.93 (95% CI = 1.18-7.29).


RESULTS
The results suggest a significant association between SDB/OSA and hypertension. However, the data are not adequate to draw firm conclusion although evidences were emerging to suggest that SDB/OSA affects blood pressure in either directions in children. Limited evidences also suggest that SDB/OSA is associated with increased sympathetic activation, decreased arterial distensibility and ventricular hypertrophy.


CONCLUSIONS
There is now increasing but not adequate evidence that childhood SDB/OSA is associated with detectable cardiovascular abnormalities.
Ng
D K
DK
Department of Paediatrics, Kwong Wah Hospital, Yaumatei, Hong Kong SAR, People's Republic of China. dkkng@ha.org.hk
Chan
C
C
Chow
A S
AS
Chow
P
P
Kwok
K
K
D000293:Adolescent; D001158:Arteries / Q000502:physiology; D001794:Blood Pressure; D002318:Cardiovascular Diseases / Q000209:etiology*; D002648:Child; D002675:Child, Preschool; D003187:Compliance; D005260:Female; D006339:Heart Rate; D006801:Humans; D006973:Hypertension / Q000209:etiology*; D017379:Hypertrophy, Left Ventricular / Q000209:etiology; D007223:Infant; D008297:Male; D012891:Sleep Apnea Syndromes / Q000150:complications; D020181:Sleep Apnea, Obstructive / Q000150:complications* / Q000503:physiopathology*