Keywords
High blood pressure
Circadian rhythm
Children
How to Cite
Copyright © | All rights reserved.
The journal holds the exclusive copyright for the publication of this article under the terms of Brazilian law 9610/98.
Partial reproduction
The use of parts of the texts, figures and questionnaire of the article is free, being mandatory the citation of the authors and journal.
Total reproduction
It is expressly prohibited and must be authorized by the journal.
Abstract
Objectives: To evaluate the relationship between circadian blood pressure measurements in children with obstructive sleep apnea (OSA) and the consequences that its dysregulation can cause in the long term. Methods: The BVS, PubMed, MEDLINE, LILACS and Uptodate databases were used, including studies published from January 2019 onwards, in English and Portuguese. To define OSA, the articles used polysomnography criteria for diagnosis and ambulatory blood pressure monitoring (ABPM) to record BP values throughout the day. Results: In 9 studies, OSA was associated with changes in blood pressure values over 24 hours, with the peak occurring in the early morning and at night during REM sleep. This population also shows a decrease in nighttime sleep. This variability is more strongly associated with worse cardiovascular outcomes when compared to elevated blood pressure alone. Final considerations: Studies confirm the relationship between OSA and circadian blood pressure changes in the pediatric age group, highlighting the need to investigate OSA symptoms and blood pressure in pediatric consultations, to carry out early diagnosis and treatment and thus avoid unwanted complications in the future.
References
AI S, et al. Blood pressure and childhood obstructive sleep apnea: A systematic review and meta-analysis. Sleep medicine reviews, 2022; 65: 101663
BARROSO WKS, et al. Diretrizes Brasileiras de Hipertensão Arterial – 2020. Arquivos Brasileiros de Cardiologia, 2021; 116(3): 516-658
BRASIL. Manual de orientação do Departamento científico de nefrologia. Hipertensão arterial na infância e adolescência. Sociedade Brasileira de Pediatria. 2019 Disponível em: https://www.sbp.com.br/fileadmin/user_upload/21635c-MO_-_Hipertensao_Arterial_Infanc_e_Adolesc.pdf. Acesso em 10 fev 2024
BRASIL. Manual de orientação do Departamento científico de nutrologia. Hipertensão arterial na infância e adolescência. Sociedade Brasileira de Pediatria. 2019 Disponível em: https://www.sbp.com.br/fileadmin/user_upload/Manual_de_Obesidade_-_3a_Ed_web_compressed.pdf. Acesso em: 10 fev. 2024
BROOKS D, et al. The relationship between sleep-disordered breathing, blood pressure, and urinary cortisol and catecholamines in children. Journal of clinical sleep medicine, 2022; 6:907–916
CHAN K, et al. Childhood OSA is an independent determinant of blood pressure in adulthood: longitudinal follow-up study. Thorax, 2019; 5: 422–431
CHAN K, et al. Disruption of blood pressure circadian rhythm in children with obstructive sleep apnea- is it a pathway leading to cardiovascular morbidities?, 2024; 47(2): zsad284
CHUANG H, et al. Hypertension in Children with Obstructive Sleep Apnea Syndrome-Age, Weight Status, and Disease Severity. Int J Environ Res Public Health, 2021; 18: 9602
DUARTE RLM, et al. Consenso em Distúrbios Respiratórios do Sono da Sociedade Brasileira de Pneumologia e Tisiologia. Jornal Brasileiro de Pneumologia, 2022; 8(4): e20220106
DELROSSO LM, et al. Ambulatory blood pressure monitoring in children undergoing polysomnography. Journal of sleep research, 2021; 30(4): e13280
GALLUCCI MA, et al. Cardiovascular issues in obstructive sleep apnea in children: A brief review. Pediatric respiratory reviews, 2021; 38: 45–50
GONG S, et al. Nocturnal dipping status and the association of morning blood pressure surge with subclinical target organ damage in untreated hypertensives. Journal of clinical hypertension, 2019; 21(9): 1286–1294
HORNE RSC, et al. Is childhood obstructive sleep apnea an independent risk factor of hypertension in adulthood? Thorax, 2024; 5: 364
KANG K, et al. Office Blood Pressure Monitoring in Children with Obesity and Obstructive Sleep Apnea. The Journal of pediatrics, 2022; 246: 138–144.
KHAN M, et al. Circadian blood pressure dysregulation in children with obstructive sleep apnea. Sleep, 2024; 47(2): zsad254
LIN J, et al. Circadian Rhythms in Cardiovascular Function: Implications for Cardiac Diseases and Therapeutic Opportunities. Med Sci Monit; 2023; 29: e942215.
MARINHO CARS, et al. Padrão de sono em crianças de 12 a 36 meses de idade. Esc. Anna Nery Rev. Enferm, 2022; 26: e20210269.
MOURA ALF, et al. Evidências científicas sobre as consequências cardiovasculares da apneia obstrutiva do sono em crianças. Brazilian Journal of Health Review, 2022; 3: 8259–8272.
MYETTE RL, et al. Blood pressure variability in children with obesity and sleep-disordered breathing following positive airway pressure treatment. Pediatric research, 2022; 92(3): 810–815.
PIRANA S, et al. Distúrbios respiratórios do sono: relação com as doenças cardiovasculares. Rev Med Minas Gerais, 2022; 32: e-32103
RÊGO ALLS, et al. Apneia do sono e alterações cardiovasculares: da disfunção endotelial até fenômenos isquêmicos e tromboembólicos. Brazilian J of Health Review, 2023; 4: 14074–14083.
RODRIGUEZ-LOPES S, et al. Does obstructive sleep apnoea contribute to obesity, hypertension and kidney dysfunction in children? A systematic review protocol. BMJ open, 2020; 10(8).
SANTOS ACG, et al. Obesidade infantil e doenças respiratórias: uma perigosa associação. Revista Acervo Saúde, 2021; 13(5): e7443.
SHANMUGAM A, et al. Impact of OSA treatment success on changes in hypertension and obesity: A retrospective cohort study. Sleep medicine, 2023; 101: 205–212.
STERGIOU G, et al. European Society of Hypertension Council and the European Society of Hypertension Working Group on Blood Pressure Monitoring and Cardiovascular Variability. European Society of Hypertension practice guidelines for office and out-of-office blood pressure measurement. Journal of hypertension, 2021; 39: 1293–1302.
TURAN T, et al. Abnormal Circadian Blood Pressure Variation is Associated with SYNTAX Scores in Hospitalized Patients with Acute Coronary Syndrome. Arquivos brasileiros de cardiologia, 2022; 119(1): 76–84.