Sleep-disordered breathing is associated with blood pressure and carotid arterial stiffness in obese children

Tagetti, Angela; Bonafini, Sara; Zaffanello, Marco; Benetti, Maria Vittoria; Vedove, Francesco Dalle; Gasperi, Emma; Cavarzere, Paolo; Gaudino, Rossella; Piacentini, Giorgio; Minuz, Pietro; Maffeis, Claudio; Antoniazzi, Franco; Fava, Cristiano

doi:10.1097/hjh.0000000000001123

Cited by 33 publications

(25 citation statements)

References 34 publications

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“…We applied the device between 6:00 p.m. and 8:00 a.m., and the data were recorded throughout the night. During the test, the children underwent recordings for ≥6 h in a quiet sleep room accompanied by one of their parents [ 19 ]. The total sleep time (TST) was calculated from the point at which the child fell asleep to the awakening, and it was reported in a nocturnal diary by the caretaker.…”

Section: Methodsmentioning

confidence: 99%

Sleep-Disordered Breathing in Children with Recurrent Wheeze/Asthma: A Single Centre Study

et al. 2017

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The relationship between asthma and sleep-disordered breathing is bidirectional due to common risk factors that promote airway inflammation. Obstructive sleep-disordered breathing and recurrent wheeze/asthma are conditions that involve the upper and the lower respiratory system, respectively. The aim of the present study was to investigate the sleep disordered breathing in children with recurrent wheeze/asthma. This was a retrospective study concerning children older than 2 years who underwent—between January 2014 and November 2016—an in-laboratory overnight polygraphic study. We match the children between those who do or do not have recurrent wheeze/asthma disease. We examined the clinical records of 137 children. We excluded eight patients because of neurological and genetic conditions. Children with recurrent wheeze/asthma (N = 28) were younger (p = 0.002) and leaner (p = 0.013) compared to non-affected children (N = 98). Children with wheeze/asthma and unaffected ones had a similar obstructive apnea-hypopnea index (p = 0.733) and oxygen desaturation index (p = 0.535). The logistic regression analysis, in which the condition of wheeze/asthma (yes/no) was a dependent variable, while demographic (age, sex, body mass index (BMI) Z-score) and polygraphic results during sleep (obstructive apnea-hypopnea index, central apnea index, peripheral oxygen saturation (SpO2), and snoring) were covariates, showed that children with wheeze/asthma had higher central apnea index (Exp(B) = 2.212; Wald 6.845; p = 0.009). In conclusion, children with recurrent wheeze/asthma showed an increased number of central sleep apneas than unaffected children. This finding may suggest a dysfunction of the breathing control in the central nervous system during sleep. Systemic or central inflammation could be the cause.

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Section: Methodsmentioning

confidence: 99%

Sleep-Disordered Breathing in Children with Recurrent Wheeze/Asthma: A Single Centre Study

et al. 2017

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“…Moreover, an association of carotid artery stiffness with the AHI has been reported in obese children (93), suggesting that vascular remodelling might begin even as early as in childhood.…”

Section: Osamentioning

confidence: 98%

Cardiorespiratory interaction with continuous positive airway pressure

Pengo¹,

Bonafini²,

Fava³

et al. 2018

J. Thorac. Dis.

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The treatment of choice for obstructive sleep apnoea (OSA) is continuous positive airway pressure therapy (CPAP). Since its introduction in clinical practice, CPAP has been used in various clinical conditions with variable and heterogeneous outcomes. In addition to the well-known effects on the upper airway CPAP impacts on intrathoracic pressures, haemodynamics and blood pressure (BP) control. However, short- and long-term effects of CPAP therapy depend on multiple variables which include symptoms, underlying condition, pressure used, treatment acceptance, compliance and usage. CPAP can alter long-term cardiovascular risk in patients with cardiorespiratory conditions. Furthermore, the effect of CPAP on the awake patient differs from the effect on the patients while asleep, and this might contribute to discomfort and removal of the use interface. The purpose of this review is to highlight the physiological impact of CPAP on the cardiorespiratory system, including short-term benefits and long-term outcomes.

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“…The complications of OSAS are sleep fragmentation, neurocognitive, behavioural (7), cardiovascular (8) and artery hypertension (9,10). Increased levels of inflammation have been found in children with OSAS (11), linking cardiovascular pathologies with secondary oxidative stress and intermittent hypoxia (12).…”

Section: Introductionmentioning

confidence: 99%

Indoor/outdoor not-voluptuary-habit pollution and sleep-disordered breathing in children: a systematic review

et al. 2017

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Background: Exposure to environmental pollutants is advocated to be a major risk factor, with increased morbidity and mortality in humans due to acute and chronic airway inflammation. The aim of the present review is to show the literature research regarding the link between the sleep-disordered breathing and exposure to indoor/outdoor pollution in children. We hypothesized that environmental air pollution can play a role in childhood sleep-disordered breathing. Methods:We conducted an electronic search in Medline (with PubMed interface), Scopus and the ISI Web of Science using the keywords "sleep" or "sleep apnea" or "sleep disordered breathing" and "pollution" and "children" in "Title/Abstract/Keywords", with language restriction (non-English paper) and no date limitation to present. The tobacco smoke pollution is well established linking and is not considered for the present subject. We examined the strength of the evidence according to the Oxford Centre for Evidence- Results: A total of 105 articles were identified, but 97 of these had to be excluded after an accurate reading of the title, abstract or full text. In the end, eight studies were selected for our analysis for a total of a total of 5,826 children. The results suggest an involvement (grade C) of environmental (not from voluptuary habits) pollution in the worsening of sleep-disordered breathing in children.Conclusions: To date, some studies reported significant differences between areas with higher and lower pollutants and the interventions on indoor pollution reduced sleep-disordered breathing in children.Therefore, although the relevance of the argument is high, the number of studies and the interest in the subject seems at this time quite limited.

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Sleep-disordered breathing is associated with blood pressure and carotid arterial stiffness in obese children

Abstract: Our data suggest that in obese children asymptomatic for sleep respiratory problems, SDB might worsen BP, in part, through an increase in arterial stiffness.

Cited by 33 publications

References 34 publications

Sleep-Disordered Breathing in Children with Recurrent Wheeze/Asthma: A Single Centre Study

Sleep-Disordered Breathing in Children with Recurrent Wheeze/Asthma: A Single Centre Study

Cardiorespiratory interaction with continuous positive airway pressure

Indoor/outdoor not-voluptuary-habit pollution and sleep-disordered breathing in children: a systematic review

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