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Acute paediatrics
Blood pressure in sleep disordered breathing
  1. J Kohyama,
  2. J S Ohinata,
  3. T Hasegawa
  1. Division of Human Ontogeny and Childhood Development, Graduate School, Tokyo Medical & Dental University, 1-5-45 Yushima, Tokyo 113-8519, Japan
  1. Correspondence to:
    Dr J Kohyama, Division of Human Ontogeny and Childhood Development, Graduate School, Tokyo Medical & Dental University, 1-5-45 Yushima, Tokyo 113-8519, Japan;
    jkohyama.ped{at}tmd.ac.jp

Abstract

Aims: To investigate blood pressure (BP) in children with sleep disordered breathing (SDB).

Methods: BP was measured during single night polysomnography in 23 suspected SDB child patients with adenotonsillar hypertrophy, but without respiratory or heart failure, or coma. The age related changes of the observed BP were normalised to the BP index. The BP indices were examined in relation to SDB measures, such as the desaturation time (percentage of time with oxygen saturation (SaO2) <90% against the total sleep time), SaO2 nadir, apnoea-hypopnoea index (AHI), and arousal index, in addition to age and body mass index (BMI).

Results: The systolic BP index during rapid eye movement sleep (REMS) tended to correlate with AHI, while the diastolic index during REM sleep showed a significant correlation with AHI. The BP indices during non-REMS and wakefulness showed no correlation with the parameters obtained. Patients with an AHI of 10 or more (n = 7, AHIhigh) had significantly higher systolic and diastolic BP indices during both wakefulness and REMS, compared with those with an AHI of less than 10 (n = 16, AHIlow). Two patients in AHIhigh showed no sleep related dip of diastolic BP, and three patients in AHIlow lacked the sleep related dip in systolic BP. By means of multiple regression analysis, age, BMI, and AHI were found to be significant predictor variables of the systolic BP index during REMS.

Conclusions: BP in paediatric SDB patients is positively correlated with the degree of SDB.

  • sleep disordered breathing
  • hypertension
  • REM sleep
  • AHI, apnoea-hypopnoea index
  • ArI, arousal index
  • BMI, body mass index
  • BP, blood pressure
  • DT, desaturation time
  • EEG, electroencephalogram
  • QDC, qualitative diagnostic calibration
  • REMS, rapid eye movement sleep
  • RIP, respiratory inductive plethysmography
  • SaO2, oxygen saturation
  • SDB, sleep disordered breathing

https://doi.org/10.1136/adc.88.2.139

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