Overnight change in brain natriuretic peptide levels in children with sleep-disordered breathing.
OBJECTIVE
Obstructive sleep-disordered breathing is accompanied by episodic increases in left ventricle afterload due to large negative swings in intrathoracic pressure and repetitive surges in arterial pressure. Brain natriuretic peptide (BNP) is released by ventricular myocytes in response to pressure and volume overload. It was hypothesized that in children with snoring, overnight change in BNP levels is correlated with severity of disturbance in respiration.


METHODS
Evening and morning plasma levels of BNP were measured in children with snoring referred for polysomnography.


METHODS
A sleep disorders laboratory in a university hospital.


METHODS
Twenty-two children with apnea-hypopnea index (AHI) > or = 5/h (mean +/- SD age, 6.4 +/- 2.5 years), 60 children with AHI < 5/h (mean age, 7 +/- 2.9 years), and 27 control subjects without snoring (mean age, 7.8 +/- 3.7 years) were recruited.


RESULTS
Overnight change in BNP (log-transformed ratio of morning-to-evening levels) was larger in children with AHI > or = 5/h, compared to those with AHI < 5/h or to control subjects (0.1 +/- 0.19 vs 0.01 +/- 0.14 vs - 0.06 +/- 0.18; p < 0.05). Children with AHI > or = 5/h had an odds ratio of 4.33 (95% confidence interval, 1.34 to 14) for change in peptide levels > 0.15 relatively to subjects with AHI < 5/h. AHI and oxygen saturation of hemoglobin nadir were significant predictors of overnight change in peptide levels.


CONCLUSIONS
In children with snoring, overnight increase in BNP levels is correlated with severity of disturbance in respiration during sleep, which may indicate presence of nocturnal cardiac strain.
Kaditis
Athanasios G
AG
Department of Pediatrics, Larissa University Hospital, Larissa 41110, Greece. KADITIA@hotmail.com
Alexopoulos
Emmanouel I
EI
Hatzi
Fotini
F
Kostadima
Eleni
E
Kiaffas
Maria
M
Zakynthinos
Epameinondas
E
Gourgoulianis
Konstantinos
K
D000293:Adolescent; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D002940:Circadian Rhythm / Q000502:physiology*; D005260:Female; D006352:Heart Ventricles / Q000473:pathology / Q000503:physiopathology; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000209:etiology / Q000473:pathology / Q000503:physiopathology; D016014:Linear Models; D008297:Male; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D017286:Polysomnography; D012720:Severity of Illness Index; D020181:Sleep Apnea, Obstructive / Q000097:blood* / Q000150:complications / Q000503:physiopathology*; D012913:Snoring / Q000097:blood / Q000503:physiopathology
D020097:Natriuretic Peptide, Brain