Sleep medicine · 2026
Nocturnal blood pressure patterns in pediatric obstructive sleep apnea: The Kids Trial study.
СтатьяМногоцентровое исследованиеНаблюдательное исследованиеНазвание и аннотация: Перевод пока не подготовлен
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Mediano Olga, Castillo-García María, Romero-Peralta Sofía, Viejo-Ayuso María Esther, Silgado-Martínez Laura, Álvarez-Balado Leticia, Forné Carles, Resano-Barrio Pilar, García-Rio Francisco, Cano-Pumarega Irene, Sánchez-de-la-Torre Manuel, Ortigado Alfonso, Fidalgo Laura, Rodríguez Ángel, López-Monzoni Sonia, Álvarez Ainhoa, Pía-Martínez Carla, Del Río Genoveva, Bragado Esther, Roncero Alejandra, García-Mediano Belén, Mato-López Álvaro, Rodríguez-Perojo Adriana, Pengo Martino F, Solano-Pérez Esther
Аннотация
UNLABELLED: Obstructive sleep apnea (OSA) in children is associated with cardiovascular risk, but its impact on sleep blood pressure (BP) remains incompletely understood.
OBJECTIVE: To assess the association between the severity of OSA, stratified by the obstructive apnea-hypopnea index (OAHI), and altered sleep BP patterns, specifically the non-dipping pattern (NDP), using ambulatory 24-h BP monitoring (ABPM).
METHODS: The Kids-Trial is a multicenter observational trial (NCT03696654) conducted in Spain, including children with suspected OSA that underwent polysomnography for its diagnosis. To estimate the impact of OAHI on the risk of NDP, a multivariable logistic regression model was constructed and odds ratio (OR) was calculated.
RESULTS: A total of 267 children were included (median age of 6 years and 42.7 % girls). When BP was assessed through z-score, significant positive trends were observed according to OSA severity in 24-h mean BP, 24-h systolic BP, sleep mean BP, sleep systolic BP, sleep diastolic BP, and NDP. A negative trend was observed for the drop in sleep mean BP. The adjusted model showed that severe OSA was independently associated with a reduced drop in mean BP (-3.68 (-6.9; -0.47); p = 0.026). Adjusted multivariable analysis of NDP showed an increased but not significant risk of NDP in severe OSA vs. non-OSA (OR = 2.76 (0.92, 8.30)).
CONCLUSION: Severe pediatric OSA was independently associated with disrupted nocturnal BP regulation, including a reduced BP dipping. These findings underscore the importance of ABPM in pediatric sleep evaluations.
CLINICAL TRIAL REGISTRATION: clinicaltrials.gov NCT03696654.
OBJECTIVE: To assess the association between the severity of OSA, stratified by the obstructive apnea-hypopnea index (OAHI), and altered sleep BP patterns, specifically the non-dipping pattern (NDP), using ambulatory 24-h BP monitoring (ABPM).
METHODS: The Kids-Trial is a multicenter observational trial (NCT03696654) conducted in Spain, including children with suspected OSA that underwent polysomnography for its diagnosis. To estimate the impact of OAHI on the risk of NDP, a multivariable logistic regression model was constructed and odds ratio (OR) was calculated.
RESULTS: A total of 267 children were included (median age of 6 years and 42.7 % girls). When BP was assessed through z-score, significant positive trends were observed according to OSA severity in 24-h mean BP, 24-h systolic BP, sleep mean BP, sleep systolic BP, sleep diastolic BP, and NDP. A negative trend was observed for the drop in sleep mean BP. The adjusted model showed that severe OSA was independently associated with a reduced drop in mean BP (-3.68 (-6.9; -0.47); p = 0.026). Adjusted multivariable analysis of NDP showed an increased but not significant risk of NDP in severe OSA vs. non-OSA (OR = 2.76 (0.92, 8.30)).
CONCLUSION: Severe pediatric OSA was independently associated with disrupted nocturnal BP regulation, including a reduced BP dipping. These findings underscore the importance of ABPM in pediatric sleep evaluations.
CLINICAL TRIAL REGISTRATION: clinicaltrials.gov NCT03696654.