Many of you have already learned about increased cardiovascular disease risk markers in patients with uncontrolled sleep apnea. When I speak with patients, they often seem to take on an opinion that the cardiovascular risk issues are have more to do with older adults and people who already have significant heart disease. Patients in their 20’s, 30’s, 40’s and even 50’s sometimes seem disinterested in the cardiac effects of sleep disordered breathing, as if they are too young to be affected by sleep related breathing affects on the heart.
In the article by Marilisa Montesano, M.D. and her colleagues at The Pediatric Department “La Sapienza” University, Il Faculty, Medicine, Rome, Italy in SLEEP (Vol 33, No. 10, Oct. 1, 2010, pp. 1349-1355.) In the study children ages 7 – 14 underwent overnight sleep studies. 18 had obstructive sleep apnea and 25 were in the control group.
The investigative group did many sophisticated analyses leading to many surprising results. One of the most significant was that children have markedly greater blood pressure if they have sleep apnea compared to those who do not.
Obstructive Sleep Apnea Group | Control Group | |
Systolic Blood Pressure | 111.7 mm Hg | 100.5 mmHg |
Diastolic Blood Pressure | 64.7 mm Hg | 57.7 mmHg |
Heart Rate | 77.0/min | 67.5/min |
Apnea/Hypopnea Index | 5.3/hour | 0.3/hour |
Statistical analysis showed a clear and direct relationship between the AHI (Apnea-Hypopnea Index: the number of apneas and hypopneas per hour) and cardiovascular parameters in these children.
It is evident that there are already cardiovascular changes in children who are suffering from obstructive sleep apnea. We must take the cardiovascular effects of sleep apnea very seriously in every sleep apnea patient and make sure we are fully managing sleep apnea in every single patient to the best of our ability.
Darius Zoroufy, M.D.
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