Year: 2025
Type: article
Abstract: Background: Children with obstructive sleep apnea (OSA) have an increased risk for high blood pressure (BP). Evidence suggests that arousals, total sleep time (TST), sleep efficiency, oxygen saturation, end-tidal carbon dioxide (ETCO 2 ) levels, inflammation, and body mass index (BMI) are associated with changes in BP. Yet, less is known about these relationships in school-aged children with OSA. Objective: This study aimed to determine factors associated with BP in school-aged children with OSA. Methods: A cross-sectional, secondary data analysis of 163 school-aged children (mean age of 7.15 ± 1.16, 62% black, 54.6% female) who participated in the Childhood Adenotonsillectomy Trial. Results: Systolic BP ( r = 0.21, p < .01) and diastolic BP (DBP; r = 0.22, p < .01) had a positive relationship with BMI percentiles. The relationship between BMI percentiles and DBP remained when accounting for race and OSA severity (β = 0.19, p = .02). DBP also had a positive relationship with the log percentage of TST with ETCO 2 ≥50 mmHg ( r = 0.23, p < .01) that persisted when accounting for BMI percentiles, OSA severity, and race (β = 0.23, p = .004). No other significant relationships were found. Conclusions: Findings suggest that BMI is a main driver of BP in school-aged children with OSA. Also, the percentage of TST with ETCO 2 ≥50 mmHg impacted BP in this sample and further research is needed to explore mechanisms behind these relationships. Clinicians and researchers should advocate for the assessment of all polysomnographic findings when assessing the risk for elevated BP and other comorbidities in children with OSA.
Authors: Shameka Rodgers Phillips, Laura Gray, Ann Hammack Johnson, Sara Davis, Heather Soistmann, Peng Li, Elizabeth Coleman, Thuy Lynch, Marti Rice
Institutions: University of Washington, Seattle Children's Research Institute, Belmont University, Texas Christian University, University of South Alabama, Penn State Health Children's Hospital, Penn State Milton S. Hershey Medical Center, University of Alabama at Birmingham, University of Alabama in Huntsville
Language: English
Subfield: Physiology
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
Funders: National Institutes of Health, National Heart, Lung, and Blood Institute, National Institute of Diabetes and Digestive and Kidney Diseases, National Institute of Child Health and Human Development, National Center for Research Resources, Eunice Kennedy Shriver National Institute of Child Health and Human Development
Awards: G130883262, G2064166219, Case Western Reserve University/Cleveland Clinic CTSA (UL1), G2862297731, A randomized controlled study of adenotonsillectomy for children, G3941653316, G4249524944, G4949749077, G5052390642, G7511203839, Child Health Equity Research Program for Post-doctoral Trainees., G76141112, G8574385681, G860149444, G9000037440, G9000055281, G9000068995, G9000093090, G9000120957, G9000199928, G9000281696, G91634571
OpenAlex ID: W4410711713