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Medline ® Abstracts for References 56-59

of 'Evaluation of suspected obstructive sleep apnea in children'

56
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Ambulatory blood pressure in children with obstructive sleep apnoea: a community based study.
AU
Li AM, Au CT, Sung RY, Ho C, Ng PC, Fok TF, Wing YK
SO
Thorax. 2008;63(9):803.
 
BACKGROUND: Childhood obstructive sleep apnoea (OSA) is increasingly being recognised. Its effects on blood pressure (BP) elevation and hypertension are still controversial.
OBJECTIVE: To evaluate the association between OSA and ambulatory BP in children.
METHODS: Children aged 6-13 years from randomly selected schools were invited to undergo overnight sleep study and ambulatory BP monitoring after completing a validated OSA questionnaire. OSA was diagnosed if the obstructive apnoea-hypopnoea index (AHI) was>1, and normal controls had AHI<1 and snoring<3 nights per week. Children with OSA were subdivided into a mild group (AHI 1-5) and moderate to severe group (AHI>5).
RESULTS: 306 subjects had valid sleep and daytime BP data. Children with OSA had significantly higher BP than normal healthy children during both sleep and wakefulness. BP levels increased with the severity of OSA, and children with moderate to severe disease (AHI>5)were at significantly higher risk for nocturnal systolic (OR 3.9 (95% CI 1.4 to 10.5)) and diastolic (OR 3.3 (95% CI 1.4 to 8.1)) hypertension. Multiple linear regression revealed a significant association between oxygen desaturation index and AHI with daytime and nocturnal BP, respectively, independent of obesity.
CONCLUSIONS: OSA was associated with elevated daytime and nocturnal BP, and is an independent predictor of nocturnal hypertension. This has important clinical implications as childhood elevated BP predicts future cardiovascular risks. Future studies should examine the effect of therapy for OSA on changes in BP.
AD
Dr A M Li, Department of Paediatrics, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong. albertmli@cuhk.edu.hk
PMID
57
TI
Ventricular dysfunction in children with obstructive sleep apnea: radionuclide assessment.
AU
Tal A, Leiberman A, Margulis G, Sofer S
SO
Pediatr Pulmonol. 1988;4(3):139.
 
Ventricular function was evaluated using radionuclide ventriculography in 27 children with oropharyngeal obstruction and clinical features of obstructive sleep apnea. Their mean age was 3.5 years (9 months to 7.5 years). Conventional clinical assessment did not detect cardiac involvement in 25 of 27 children; however, reduced right ventricular ejection fraction (less than 35%) was found in 10 (37%) patients (mean: 19.5 +/- 2.3% SE, range: 8-28%). In 18 patients wall motion abnormality was detected. In 11 children in whom radionuclide ventriculography was performed before and after adenotonsillectomy, right ventricular ejection fraction rose from 24.4 +/- 3.6% to 46.7 +/- 3.4% (P less than 0.005), and in all cases wall motion showed a definite improvement. In five children, left ventricular ejection fraction rose greater than 10% after removal of oropharyngeal obstruction. It is concluded that right ventricular function may be compromised in children with obstructive sleep apnea secondary to adenotonsillar hypertrophy, even before clinical signs of cardiac involvement are present.
AD
Pediatric Division, Soroka University Hospital, Beer-Sheva, Israel.
PMID
58
TI
Sleep apnea-associated hypertension and reversible left ventricular hypertrophy.
AU
Ross RD, Daniels SR, Loggie JM, Meyer RA, Ballard ET
SO
J Pediatr. 1987 Aug;111(2):253-5.
 
AD
PMID
59
TI
Tonsillar enlargement and failure to thrive.
AU
Hodges S, Wailoo MP
SO
Br Med J (Clin Res Ed). 1987 Aug;295(6597):541-2.
 
AD
Department of Child Health, Leicester Royal Infirmary.
PMID