title: Improvement of sleep-disordered breathing in children is associated with a reduction in overnight blood pressure.
abstract: OBJECTIVE
  Childhood sleep-disordered breathing (SDB) is associated with elevated blood pressure (BP); however, little is known about the long-term outcomes in this population. We aimed to assess long-term changes in overnight BP in children with SDB.
  
  
  METHODS
  Forty children with previously diagnosed SDB and 20 nonsnoring control participants underwent repeat overnight polysomnography (PSG) with continuous BP measurement 4years after the original diagnosis. At follow-up, children aged 11-16years were categorized into 2 groups of resolved (absence of snoring and obstructive apnea-hypopnea index [OAHI]⩽1) or unresolved (continued to snore or had an OAHI >1) SDB.
  
  
  RESULTS
  There were no group differences in age, sex, or body mass index (BMI) z score. OAHI was lower at follow-up (P<.05) in both the resolved (n=18) and unresolved (n=22) groups. BP was elevated during wake and sleep in both SDB groups compared to the control group at baseline (P<.01 for all), but it decreased by 5-15mmHg at follow-up during sleep for both SDB groups (P<.05 for all). BP during wake was unchanged in the SDB groups at follow-up but increased in the control group (P<.05). At follow-up, BP did not differ between the control group and the SDB groups during wake or sleep. Improved oxygen saturation (SpO2) during sleep was a significant predictor of a reduction in BP.
  
  
  CONCLUSIONS
  SDB improved over the 4-year follow-up and both resolved and unresolved groups exhibited a significant reduction in BP during sleep, with levels similar to the control group. Our study highlights the fact that even small improvements can improve the cardiovascular effects of SDB.
authors.affiliation: The Ritchie Centre, Monash Institute of Medical Research, Monash University, Melbourne, Australia.
authors.forename: Anna
authors.initials: A
authors.lastname: Vlahandonis
authors.forename: Gillian M
authors.initials: GM
authors.lastname: Nixon
authors.forename: Margot J
authors.initials: MJ
authors.lastname: Davey
authors.forename: Lisa M
authors.initials: LM
authors.lastname: Walter
authors.forename: Rosemary S C
authors.initials: RS
authors.lastname: Horne
mesh_terms: D000293:Adolescent; D001794:Blood Pressure / Q000502:physiology*; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D008297:Male; D017156:Photoplethysmography; D017286:Polysomnography; D012890:Sleep / Q000502:physiology; D012891:Sleep Apnea Syndromes / Q000503:physiopathology* / Q000628:therapy*; D012895:Sleep, REM / Q000502:physiology; D012913:Snoring / Q000503:physiopathology / Q000628:therapy
keywords: Blood pressure; Follow-up; Heart rate; Obstructive sleep apnea; Pediatric sleep-disordered breathing; Treatment