title: Ambulatory blood pressure monitoring in children with obstructive sleep apnea and primary snoring.
abstract: OBJECTIVE
  To evaluate the systemic blood pressure (BP) during daytime and nighttime in children with sleep breathing disorders (SBD) and compare parameters of BP in children with diagnosis of obstructive sleep apnea syndrome (OSA) to those one with primary snoring (PS).
  
  
  METHODS
  Children, both genders, aged from 8 to 12 years, with symptoms of SBD realized an overnight polysomnography followed by a 24h recording of ambulatory BP.
  
  
  RESULTS
  All subjects presented with a history of snoring 7 nights per week. Children who have apnea/hipoapnea index ≥ four or a apnea index ≥ one presented a mean BP of 93±7mmHg and 85±9mmHg diurnal and nocturnal respectively whereas children who have a apnea/hipoapnea < four or a apnea index < one presented 90±7mmHg and 77±2mmHg. Eight children out of fourteen, from OSA group, lost the physiologic nocturnal dipping of the blood pressure. Among OSA children 57% were considered non-dippers. Two (16%) have presented absence of nocturnal dipping among children with primary snoring. The possibility of OSA children loosing physiologic blood pressure dipping was 6.66 higher than the possibilities of patients from PS group.
  
  
  CONCLUSIONS
  Our results indicate that children with sleep apnea syndrome exhibit a higher 24h blood pressure when compared with those of primary snoring in form of decreased degree of nocturnal dipping and increased levels of diastolic and mean blood pressure, according to previous studies in literature. OSA in children seems to be associated to the development of hypertension or other cardiovascular disease.
authors.affiliation: Ophthalmology, Otorhinolaryngology and Head & Neck Surgery Department, Botucatu School of Medicine-São Paulo State University, Botucatu, SP, Brazil. silke@fmb.unesp.br
authors.forename: Silke Anna Theresa
authors.initials: SA
authors.lastname: Weber
authors.forename: Victor José Barbosa dos
authors.initials: VJ
authors.lastname: Santos
authors.forename: Graziela de Oliveira
authors.initials: Gde O
authors.lastname: Semenzati
authors.forename: Luis Cuadrado
authors.initials: LC
authors.lastname: Martin
mesh_terms: D000367:Age Factors; D000553:Ambulatory Care / Q000379:methods; D001794:Blood Pressure / Q000502:physiology; D018660:Blood Pressure Monitoring, Ambulatory; D015992:Body Mass Index; D016022:Case-Control Studies; D002648:Child; D002940:Circadian Rhythm; D015331:Cohort Studies; D016001:Confidence Intervals; D005260:Female; D006801:Humans; D006973:Hypertension / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology; D015994:Incidence; D008297:Male; D015999:Multivariate Analysis; D016017:Odds Ratio; D017286:Polysomnography / Q000379:methods; D012016:Reference Values; D018570:Risk Assessment; D012720:Severity of Illness Index; D012737:Sex Factors; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology; D012913:Snoring / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology; D018709:Statistics, Nonparametric