0830 Polysomnography Differences in Children with and Without Hypertension in the Absence of OSA
SLEEP(2024)
Abstract
Abstract Introduction There is growing evidence linking hypertension and sleep disturbances in adults, even in the absence of OSA. Even though hypertension is associated with OSA in children, there is a lack of data on influence of the non-respiratory parameters of sleep on hypertension. The objective of this study is to compare respiratory and non-respiratory sleep parameters in children with and without hypertension, among those without OSA based on PSG. Methods IRB approved retrospective chart review of patients ages 8-17 years, who underwent PSG at Nemours Children’s Hospital, DE, between January 2020 and May 2023. Data was collected on demographics, anthropometrics, comorbid medical conditions, and PSG findings from EMR. Hypertension was defined as an average systolic (SBP) and/or diastolic blood pressure (DBP) ≥ 95th percentile for gender, age, and height based on AAP Clinical Practice Guidelines. An average of 5 BP measurements from clinic visits within year prior to the date of the PSG were analyzed. Height percentiles were calculated using CDC guidelines. Descriptive and comparative statistics were performed to compare PSG findings between non-hypertensive and hypertensive youth. Results We collected data on 228 children. The cohort (n=228) was split into non-OSA and OSA groups based on PSG results. Among the non-OSA group (n=108), 22 individuals were categorized as hypertensive (20.3%). Mean age was 11.4 years and mean BMI z-score was 2.7 (1.83) among the hypertensive group and 12.6 years and 1.12 (2.04) respectively among the non-hypertensive group, with a significant difference in BMI z-score (p< 0.001). Respiratory and non-respiratory sleep parameters were similar, except average heart rate during sleep was significantly higher in the hypertensive group; 79.3 BPM (±11.34) vs 70.9 BPM (±10.07) for the non-hypertensive group (p = 0.002). Conclusion In children without OSA, there were no observed differences in respiratory or non-respiratory parameters between the hypertensive and non-hypertensive groups. Children in hypertensive group had a significantly higher BMI Z-score and average heart rate during sleep. This may suggest that obesity and sympathetic activation are important in the pathogenesis of pediatric hypertension even in the absence of detectable sleep disorders. Future studies with larger cohorts are necessary to further explore these relationships. Support (if any)
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