S09: Effects of sleep-disordered breathing on blood pressure and its regulation: Evidence from preschoolers to adolescents
Saturday, April 28 | 4:00pm-5:30pm | Room Bordeaux
Chair: Albert Martin Li (Hong Kong)
Autonomic impact of sleep-disordered breathing in preschool children
Rosemary Horne (Australia)
Effects of obstructive sleep apnoea on blood pressure: Data from a longitudinal follow-up study
Kate Chan (Hong Kong)
The association of sleep-disordered breathing with elevated blood pressure in adolescent subjects: Penn State Child Cohort
Edward Bixler (USA)
Sleep-disordered breathing causes cardiovascular dysfunction – what’s the mechanism?
Raouf Amin (USA)
Summary of symposium:
Sleep-disordered breathing (SDB) is a common condition and its spectrum includes frequent snoring to obstructive sleep apnoea (OSA). A variety of complications has been reported in children with SDB and amongst which deficits in cardiovascular function are important sequelae. There is accumulating evidence from longitudinal epidemiological studies to support the concept of developmental origins of adult disease. The roots of adult cardiovascular diseases including hypertension, extend back into early life, stressing the importance of early detection and treatment. Previous studies have documented elevated blood pressure (BP) and even hypertension in children with untreated SDB and especially OSA. This has far-reaching long term implications as childhood BP levels track and are significantly and positively associated with adult BP levels. Understanding the current literature and pathophysiological mechanism linking SDB with cardiovascular dysregulation will help practicing clinicians in instituting the most appropriate management for childhood SDB. In this symposium, the speakers will review the latest research findings on the effects of SDB on BP and its regulation, results from cross-sectional, longitudinal and interventional studies across different paediatric age ranges will be presented. The pathophysiological mechanism on how SDB causes cardiovascular dysfunction will also be discussed.
Prof. Rosemary Horne will elaborate on cardiovascular functioning deficits evident in preschool children (3-5 years) with SDB, focusing on alterations to heart rate, pulse transit time, heart rate variability and urinary catecholamines. These studies highlight that cardiovascular function is already altered even at this you age. She will also present findings on the effects of SDB resolution in mitigating these outcome measures, findings which suggest earlier diagnosis and treatment can improve cardiovascular function.
There is limited longitudinal data on childhood SDB in the current literature. Dr. Kate Chan will discuss findings from a recently completed follow-up study of a cohort of primary school children as they underwent repeat assessment 10 years from baseline. The research question examined whether baseline OSA severity could predict BP levels at follow-up.
Prof. Edward Bixler will explore the association of SDB with elevated BP in adolescents while controlling for various relevant risk factors. The subjects are derived from the Penn State Child Cohort, a representative population sample that has been followed for over 8 years.
Lastly Prof. Raouf Amin will provide an overview on the pathophysiology linking SDB and cardiovascular dysfunction. Having a thorough knowledge of the underlying mechanism will allow prescription of the most suitable treatment for children and adolescents with SDB.
Upon completion of this CME activity, participants should be able to understand:
1 The consequences of SDB on blood pressure and its regulation
2 Changes to cardiovascular function and regulation following resolution of SDB
3 The mechanism on how SDB affects cardiovascular function and control
Clinicians, sleep researchers, allied health care workers interested in the field of childhood SDB