24‐Hour Ambulatory Blood Pressure Variability in Children with Obstructive Sleep Apnea

Objective To evaluate blood pressure (BP) variability in 24‐hour ambulatory BP monitoring in children with obstructive sleep apnea (OSA). Study Design Case series study. Methods Children aged 4 to 16 years with clinical symptoms were recruited in a tertiary medical center. Overnight polysomnography and 24‐hour recordings of ambulatory BP were performed for each child. The severity of OSA was classified as primary snoring (apnea‐hypopnea index [AHI] < 1), mild OSA (1 ≤ AHI < 5), moderate OSA (10 > AHI ≥ 5), and severe OSA (AHI ≥ 10). The standard deviation of mean BP was used as an indicator of BP variability. Results A total of 550 children were included (mean age: 7.6 years; 70% were boys; 20% were obese). Compared with the children with primary snoring, children with severe OSA exhibited significantly higher nighttime systolic BP (108.0 vs. 100.5 mmHg, P  < .001), nighttime diastolic BP (58.9 vs 55.6 mmHg, P  = .002), nighttime mean arterial pressure (75.3 vs. 70.5 mmHg, P  < .001), nighttime systolic BP load (40.5% vs. 25.0%, P  < .001), nighttime diastolic BP load (25.3% vs. 12.9%, P  < .001), and nighttime systolic BP variability (11.4 vs. 9.6, P  = .001). Multiple linear regression analyses revealed an independent association between AHI and nighttime systolic BP variability (regression coefficient = 0.31, 95% CI = 0.06–0.56, P  = .015) after adjustment for age, gender, adiposity, and hypertensive status. Conclusions OSA in children is associated with increased BP and BP variability. Level of Evidence 4 Laryngoscope , 131:2126–2132, 2021