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Original Research: Sleep Disorders |

A 4-Year Prospective Follow-up Study of Childhood OSA and Its Association With BPChildhood OSA and BP: A Follow-up Study

Albert M. Li, MD; Chun T. Au, MPhil; Crystal Ng, MPhil; Hugh S. Lam, MB; Crover K. W. Ho, RPSGT; Yun K. Wing, MB
Author and Funding Information

From the Department of Pediatrics (Drs Li and Lam, Mr Au, and Ms Ng) and Department of Psychiatry (Mr Ho and Dr Wing), Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong.

Correspondence to: Albert M. Li, MD, Department of Pediatrics, Prince of Wales Hospital, 30-32 Ngan Shing St, Shatin, Hong Kong; e-mail: albertmli@cuhk.edu.hk


Part of this article has been presented in abstract form at the 8th Congress of Asian Society for Pediatric Research, May 17-19, 2012, Seoul, Korea.

Funding/Support: This study was funded by the Research Grants Council of the Hong Kong Special Administrative Region, China [CUHK470108].

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.


Chest. 2014;145(6):1255-1263. doi:10.1378/chest.13-1333
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Background:  Childhood OSA is a prevalent condition associated with raised BP as documented in cross-sectional studies. This study aimed to determine whether baseline or change in OSA severity was associated with ambulatory BP at 4-year follow-up.

Methods:  Children who participated in our previous OSA prevalence research were invited to undergo a repeat overnight sleep study and 24-h ambulatory BP monitoring in this 4-year follow-up study. BP parameters of subjects with differing baseline OSA severity, that is, obstructive apnea-hypopnea index (OAHI) < 1/h, 1 to 5/h, and > 5/h, were compared. Overweight and normal-weight children were analyzed separately.

Results:  One hundred eighty-five of 306 subjects (60%) were included in the analysis, of whom 58 were overweight at baseline. Linear increasing trends of wake systolic BP (SBP), wake diastolic BP (DBP), and sleep SBP z scores at follow-up were found across groups of increasing baseline OSA severity in the normal weight but not in the overweight subgroup. After adjusting for BMI z score, baseline OAHI was independently associated with all BP z scores at follow-up but not associated with changes in BP z scores across 4 years. On the other hand, change in OAHI was independently associated with sleep SBP and DBP z scores at follow-up and with changes in sleep SBP and DBP z scores across 4 years.

Conclusions:  This study provides longitudinal data as additional proof that childhood OSA is associated with elevated BP independent of obesity.

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