Blood Pressure is Elevated in Children with Primary Snoring

Objectives

To compare ambulatory blood pressure (ABP) in nonoverweight, prepubertal children with and without primary snoring (PS), and to investigate whether PS is a part of the dose-response relationship between sleep-disordered breathing (SDB) and BP in children.

Study design

This was a cross-sectional community-based study involving 190 children age 6 to 13 years. Each participant underwent an overnight sleep study and ABP monitoring after completing a validated sleep symptoms questionnaire. Individual systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean arterial BP were calculated for wake and sleep periods. Subjects were hypertensive if mean SBP or DBP was > 95th percentile (relative to sex and height) of reference.

Results

A total of 56 nonsnoring controls, 46 children with PS, 62 children with an apnea-hypopnea index (AHI) of 1 to 3, and 26 children with an AHI > 3 were identified. The daytime and nighttime BP increased across the severity spectrum of SDB. The dose-response trends for the proportion of subjects with nighttime systolic and diastolic hypertension also were significant. Nighttime DBP was significantly higher in the children with PS compared with controls after adjusting for age, sex, and body mass index.

Conclusions

PS was demonstrated to be an aspect of the dose-response relationship between SDB and BP in children and should not be considered completely benign.

ABP, Ambulatory blood pressure, AHI, Apnea-hypopnea index, BMI, Body mass index, BP, Blood pressure, DBP, Diastolic blood pressure, IQR, Interquartile range, MAP, Mean arterial pressure, ODI, Oxygen desaturation index, OSA, Obstructive sleep apnea, PS, Primary snoring, PSG, Polysomnography, SBP, Systolic blood pressure, SD, Standard deviation, SDB, Sleep-disordered breathing, SpO₂, Oxyhemoglobin saturation