Overweight and obese children with sleep disordered breathing have elevated arterial stiffness

Lisa M. Walter, Knarik Tamanyan, Albert P Limawan, Sarah N. Biggs, Aidan J. Weichard, Margot J. Davey, Gillian M. Nixon, Rosemary S.C. Horne

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Background: The prevalence of obese children with sleep disordered breathing (SDB) is increasing. Obesity and SDB are independent cardiovascular risk factors, of which arterial stiffness is an early sign. Pulse wave velocity (PWV), is a marker of arterial stiffness and central systolic blood pressure (cSBP) is a better predictor of cardiovascular outcome than peripheral blood pressure. Therefore, we aimed to determine PWV and cSBP in overweight/obese or normal weight children with sleep disordered breathing (SDB), and non-snoring normal weight controls. Methods: Children (3-18 y) with SDB (overweight/obese [BMI z-scores ≥ 1.04], n = 48; normal weight n = 44) referred for clinical assessment of SDB and normal weight non-snoring controls recruited from the community (n = 38) underwent overnight polysomnography. PWV was calculated using photoplethysmography. cSBP was calculated using applanation tonometry in a subset of children older than 8 y (n = 55) who had usable waveforms. Results: Overweight/obese SDB group had higher PWV (mean cm/s (95% CI); wake: 366 (355–380); sleep: 340 (324–357)), than the normal-weight SDB group (wake: 257 (247–267), p = 0.002; sleep: 255 (242–269), p = 0.005), and non-snoring controls (wake: 238 (226–249), p = 0.002; sleep: 235 (220–250), p < 0.001). The normal-weight SDB group had higher PWV than controls (p = 0.03). Overweight/obese children with SDB had higher cSBP (105 (100–110) mmHg) compared with the normal weight children with SDB (96 (90–102)) and the non-snoring controls (97 (91–104); p < 0.05 for both). Conclusion: This study suggests that overweight/obesity substantially worsens the cardiovascular sequelae of SDB, highlighting the imperative to treat obesity and SDB in children early in order to reduce future cardiovascular disease risk.

Original languageEnglish
Pages (from-to)187-193
Number of pages7
JournalSleep Medicine
Volume48
DOIs
Publication statusPublished - 1 Aug 2018

Keywords

  • Cardiovascular
  • Obstructive sleep apnoea
  • Pediatric

Cite this

@article{709902977055455ab6b99424b3c929c3,
title = "Overweight and obese children with sleep disordered breathing have elevated arterial stiffness",
abstract = "Background: The prevalence of obese children with sleep disordered breathing (SDB) is increasing. Obesity and SDB are independent cardiovascular risk factors, of which arterial stiffness is an early sign. Pulse wave velocity (PWV), is a marker of arterial stiffness and central systolic blood pressure (cSBP) is a better predictor of cardiovascular outcome than peripheral blood pressure. Therefore, we aimed to determine PWV and cSBP in overweight/obese or normal weight children with sleep disordered breathing (SDB), and non-snoring normal weight controls. Methods: Children (3-18 y) with SDB (overweight/obese [BMI z-scores ≥ 1.04], n = 48; normal weight n = 44) referred for clinical assessment of SDB and normal weight non-snoring controls recruited from the community (n = 38) underwent overnight polysomnography. PWV was calculated using photoplethysmography. cSBP was calculated using applanation tonometry in a subset of children older than 8 y (n = 55) who had usable waveforms. Results: Overweight/obese SDB group had higher PWV (mean cm/s (95{\%} CI); wake: 366 (355–380); sleep: 340 (324–357)), than the normal-weight SDB group (wake: 257 (247–267), p = 0.002; sleep: 255 (242–269), p = 0.005), and non-snoring controls (wake: 238 (226–249), p = 0.002; sleep: 235 (220–250), p < 0.001). The normal-weight SDB group had higher PWV than controls (p = 0.03). Overweight/obese children with SDB had higher cSBP (105 (100–110) mmHg) compared with the normal weight children with SDB (96 (90–102)) and the non-snoring controls (97 (91–104); p < 0.05 for both). Conclusion: This study suggests that overweight/obesity substantially worsens the cardiovascular sequelae of SDB, highlighting the imperative to treat obesity and SDB in children early in order to reduce future cardiovascular disease risk.",
keywords = "Cardiovascular, Obstructive sleep apnoea, Pediatric",
author = "Walter, {Lisa M.} and Knarik Tamanyan and Limawan, {Albert P} and Biggs, {Sarah N.} and Weichard, {Aidan J.} and Davey, {Margot J.} and Nixon, {Gillian M.} and Horne, {Rosemary S.C.}",
year = "2018",
month = "8",
day = "1",
doi = "10.1016/j.sleep.2018.05.007",
language = "English",
volume = "48",
pages = "187--193",
journal = "Sleep Medicine",
issn = "1389-9457",
publisher = "Elsevier",

}

Overweight and obese children with sleep disordered breathing have elevated arterial stiffness. / Walter, Lisa M.; Tamanyan, Knarik; Limawan, Albert P; Biggs, Sarah N.; Weichard, Aidan J.; Davey, Margot J.; Nixon, Gillian M.; Horne, Rosemary S.C.

In: Sleep Medicine, Vol. 48, 01.08.2018, p. 187-193.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Overweight and obese children with sleep disordered breathing have elevated arterial stiffness

AU - Walter, Lisa M.

AU - Tamanyan, Knarik

AU - Limawan, Albert P

AU - Biggs, Sarah N.

AU - Weichard, Aidan J.

AU - Davey, Margot J.

AU - Nixon, Gillian M.

AU - Horne, Rosemary S.C.

PY - 2018/8/1

Y1 - 2018/8/1

N2 - Background: The prevalence of obese children with sleep disordered breathing (SDB) is increasing. Obesity and SDB are independent cardiovascular risk factors, of which arterial stiffness is an early sign. Pulse wave velocity (PWV), is a marker of arterial stiffness and central systolic blood pressure (cSBP) is a better predictor of cardiovascular outcome than peripheral blood pressure. Therefore, we aimed to determine PWV and cSBP in overweight/obese or normal weight children with sleep disordered breathing (SDB), and non-snoring normal weight controls. Methods: Children (3-18 y) with SDB (overweight/obese [BMI z-scores ≥ 1.04], n = 48; normal weight n = 44) referred for clinical assessment of SDB and normal weight non-snoring controls recruited from the community (n = 38) underwent overnight polysomnography. PWV was calculated using photoplethysmography. cSBP was calculated using applanation tonometry in a subset of children older than 8 y (n = 55) who had usable waveforms. Results: Overweight/obese SDB group had higher PWV (mean cm/s (95% CI); wake: 366 (355–380); sleep: 340 (324–357)), than the normal-weight SDB group (wake: 257 (247–267), p = 0.002; sleep: 255 (242–269), p = 0.005), and non-snoring controls (wake: 238 (226–249), p = 0.002; sleep: 235 (220–250), p < 0.001). The normal-weight SDB group had higher PWV than controls (p = 0.03). Overweight/obese children with SDB had higher cSBP (105 (100–110) mmHg) compared with the normal weight children with SDB (96 (90–102)) and the non-snoring controls (97 (91–104); p < 0.05 for both). Conclusion: This study suggests that overweight/obesity substantially worsens the cardiovascular sequelae of SDB, highlighting the imperative to treat obesity and SDB in children early in order to reduce future cardiovascular disease risk.

AB - Background: The prevalence of obese children with sleep disordered breathing (SDB) is increasing. Obesity and SDB are independent cardiovascular risk factors, of which arterial stiffness is an early sign. Pulse wave velocity (PWV), is a marker of arterial stiffness and central systolic blood pressure (cSBP) is a better predictor of cardiovascular outcome than peripheral blood pressure. Therefore, we aimed to determine PWV and cSBP in overweight/obese or normal weight children with sleep disordered breathing (SDB), and non-snoring normal weight controls. Methods: Children (3-18 y) with SDB (overweight/obese [BMI z-scores ≥ 1.04], n = 48; normal weight n = 44) referred for clinical assessment of SDB and normal weight non-snoring controls recruited from the community (n = 38) underwent overnight polysomnography. PWV was calculated using photoplethysmography. cSBP was calculated using applanation tonometry in a subset of children older than 8 y (n = 55) who had usable waveforms. Results: Overweight/obese SDB group had higher PWV (mean cm/s (95% CI); wake: 366 (355–380); sleep: 340 (324–357)), than the normal-weight SDB group (wake: 257 (247–267), p = 0.002; sleep: 255 (242–269), p = 0.005), and non-snoring controls (wake: 238 (226–249), p = 0.002; sleep: 235 (220–250), p < 0.001). The normal-weight SDB group had higher PWV than controls (p = 0.03). Overweight/obese children with SDB had higher cSBP (105 (100–110) mmHg) compared with the normal weight children with SDB (96 (90–102)) and the non-snoring controls (97 (91–104); p < 0.05 for both). Conclusion: This study suggests that overweight/obesity substantially worsens the cardiovascular sequelae of SDB, highlighting the imperative to treat obesity and SDB in children early in order to reduce future cardiovascular disease risk.

KW - Cardiovascular

KW - Obstructive sleep apnoea

KW - Pediatric

UR - http://www.scopus.com/inward/record.url?scp=85049108317&partnerID=8YFLogxK

U2 - 10.1016/j.sleep.2018.05.007

DO - 10.1016/j.sleep.2018.05.007

M3 - Article

VL - 48

SP - 187

EP - 193

JO - Sleep Medicine

JF - Sleep Medicine

SN - 1389-9457

ER -