Long-term changes in blood pressure control in elementary school-aged children with sleep-disordered breathing

In adults sleep-disordered breathing (SDB) has been associated with impaired baroreflex control of blood pressure (BP), which has been linked to increased cardiovascular morbidity. In children, the long-term effects of SDB on baroreflex sensitivity (BRS) and BP variability (BPV) are unknown. METHODS: Children previously diagnosed with SDB (n=40) and 20 nonsnoring controls aged 11-16y underwent overnight polysomnography with continuous BP measurement, four years after the original diagnosis. At follow-up, SDB was categorized as resolved (absence of snoring and obstructive apnea hypopnea index (OAHI)1) or unresolved (continued to snore or had an OAHI>1). BRS and BPV were calculated using cross-spectral analysis and power spectral analysis, respectively. RESULTS: Only children with resolved obstructive sleep apnea (OSA) at follow-up demonstrated an increase in BRS from 9.7+/-3(msmmHg-1) at baseline to 11.8+/-4(msmmHg-1) at follow-up (P=.03). However, children with all severities of both resolved and unresolved SDB showed a significant decrease in BPV from baseline to follow-up (a decrease in total power BPV (P