Childhood Obstructive Sleep Apnea May Impact Blood Pressure, Heart Health

OSA is associated with cardiovascular disease in adults, but less is known about how the condition affects the immediate and long-term heart health of children and adolescents.

Obstructive sleep apnea (OSA) in children and adolescents may be associated with elevated blood pressure and changes in heart structure, according to a new scientific statement published in the Journal of the American Heart Association. OSA is associated with cardiovascular disease in adults, but less is known about how the condition affects the immediate and long-term heart health of children and adolescents.

“The likelihood of children having disordered breathing during sleep and, in particular, obstructive sleep apnea, may be due to enlargement of the tonsils, adenoids or a child’s facial structure, however, it is important for parents to recognize that obesity also puts kids at risk for obstructive sleep apnea,” said Carissa M. Baker-Smith, MD, MPH, MS, director of pediatric preventive cardiology at the Nemours Children’s Hospital in Wilmington, Delaware, and associate professor of pediatric cardiology at Sidney Kimmel Medical College at Thomas Jefferson University in Philadelphia, in a press release. “Sleep disruptions due to sleep apnea have the potential to raise blood pressure and are linked with insulin resistance and abnormal lipids, all of which may adversely impact overall cardiovascular health later in life.”

According to the research reviewed for the statement, an estimated 1% to 6% of children have OSA. Further, between 30% and 40% of adolescents who meet the criteria for obesity have OSA. OSA has impacts on emotional health, as well as the immune, metabolic, and cardiovascular systems in children and adolescents.

“Obesity is a significant risk factor for sleep disturbances and obstructive sleep apnea, and the severity of sleep apnea may be improved by weight loss interventions, which then improves metabolic syndrome factors such as insulin sensitivity,” Baker-Smith said in the release. “We need to increase awareness about how the rising prevalence of obesity may be impacting sleep quality in kids and recognize sleep-disordered breathing as something that could contribute to risks for hypertension and later cardiovascular disease.”

The research further suggests that children and adolescents with OSA may also have higher blood pressure. Sleeping blood pressure is typically 10% lower than a person’s blood pressure level when awake; however, children and youth with OSA have a smaller dip in blood pressure while asleep, which may indicate abnormal blood pressure regulation, according to the investigators.

Other conditions of concern include metabolic syndrome and pulmonary hypertension. The writing committee specified a need for further research into cardiovascular disease risk associated with OSA in childhood that incorporates 24-hour blood pressure monitoring and measures of metabolic syndrome factors.

REFERENCE

Obstructive sleep apnea is common in kids and may impact blood pressure, heart health [news release]. EurekAlert; August 18, 2021. Accessed August 18, 2021. https://www.eurekalert.org/news-releases/925304