Obstructive sleep apnea and hypertension

Abstract

Sleep is a vital physiologic phenomenon that involves multiple processes such as regulation of breathing during sleep. In children, sleepdisordered breathing results in daytime impairment, cognitive-behavioral problems, as well as cardiovascular effects. The relationship between obstructive sleep apnea (OSA) and systemic hypertension (HTN) is not well defined in children. There is growing evidence to suggest an association between these two conditions, particularly when blood pressure is measured during sleep, and even long-term follow-up data regarding OSA and BP in youth. There is also some evidence suggesting an independent effect of OSA on left ventricular geometry changes which has been shown to improve after treatment of OSA. Certainly, obesity is a factor in the associations between OSA, HTN, and left ventricular geometry changes. The interaction and causal relationship is still unknown, but recent studies are adding to the literature to inform this interaction. Therefore, the National High Blood Pressure Education Program Working Group recommends screening for OSA as a comorbid condition in children with HTN.