0761 Continuous Positive Airway Pressure Reverses Systolic Blood Pressure Elevation In Children With Obstructive Sleep Apnea

Abstract

Introduction: Obstructive sleep apnea (OSA) is associated with elevated blood pressure (BP). Children with obesity are at higher risk of OSA and hypertension. We hypothesized that children with untreated OSA have higher BP and that continuous positive airway pressure (CPAP) treatment in children with OSA reduces BP Methods: Retrospective chart review of children aged 7 to 17 with snoring/OSA. Twenty-five children with OSA untreated, 25 children with OSA treated with CPAP and 25 habitual snorers were included. All children underwent polysomnography (PSG) and had an initial visit and a follow up visit 6 months later. None had previous diagnosis of hypertension or were on medications that affect BP. Data collected at each visit included age, body mass index (BMI), BP, heart rate (HR), apnea hypopnea index (AHI), oxygen saturation nadir, and PSG parameters Results: There was no statistically significant difference in age or AHI among groups. At initial visit snorers had HR [median(25/75 percentile)] 77(73/93), systolic BP 112(105/114); the untreated OSA children had HR 86(80/100), systolic BP 121(115/128), and the treated OSA children had HR 87(84/103), systolic BP 118/112/131). At the follow up, snorers had HR 83 (76/91), systolic BP 112(105/115), untreated OSA had HR 89(77/99), systolic BP 121 (115/128), and treated OSA had HR 83(77/95), systolic BP 112(106/122). There was no significant change in diastolic BP in the 3 groups. At baseline, the systolic BP was statistically higher in the two OSA groups than the snorers. In the OSA treated with CPAP the systolic BP decreased significantly to the level of the snorers group. Heart rate decreased in the CPAP group. BMI slightly increased in all groups. The benefit of CPAP on BP and HR was in spite of this BMI increase and the BP decrease was significantly higher in patients with higher BMI at baseline. Conclusion(s): Children with OSA have higher systolic BP than habitual snorers. Treatment with CPAP in those children reduced their systolic BP and HR in spite of a small increase in their BMI.