Cardiovascular changes in children with snoring and obstructive sleep apnoea.
BACKGROUND
Adults with obstructive sleep apnoea (OSA) are well documented to be at high risk for cardiovascular abnormalities. Growing evidence suggests that OSA is also associated with cardiovascular consequences in children. The purpose of this review is to examine the available data on this association in children.


METHODS
Primary studies were extracted from a MEDLINE search limited to those published between 1970 and 2008. The keywords used included child, sleep disordered breathing, sleep apnoea, snoring, blood pressure and hearts. The relevant articles were selected by consensus between 2 authors.


RESULTS
The results suggested that OSA was consistently associated with hypertension. Meta-analysis of risk of hypertension in those with high apnoea-hypopnoea index was undertaken. A combined odds ratio equal to 3.15 was found (95% confidence interval, 2.01 to 4.93). There was evidence for increased sympathetic activation, decreased arterial distensibility and ventricular hypertrophy in children with OSA.


CONCLUSIONS
Childhood OSA is associated with blood pressure dysregulation. The association of OSA with other cardiovascular morbidities requires further study in view of the limited data available currently.
Kwok
Ka-li
KL
Department of Paediatrics, Kwong Wah Hospital, Hong Kong SAR, China.
Ng
Daniel K
DK
Chan
Chung-hong
CH
D050197:Atherosclerosis / Q000503:physiopathology; D001794:Blood Pressure / Q000502:physiology; D002319:Cardiovascular System / Q000503:physiopathology*; D002536:Cerebral Arteries / Q000503:physiopathology; D002648:Child; D004730:Endothelium, Vascular / Q000503:physiopathology; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D006973:Hypertension / Q000503:physiopathology; D017379:Hypertrophy, Left Ventricular / Q000503:physiopathology; D011660:Pulmonary Heart Disease / Q000503:physiopathology; D012039:Regional Blood Flow; D020181:Sleep Apnea, Obstructive / Q000150:complications / Q000503:physiopathology*; D016276:Ventricular Function