Anne Tsampalieros1, Henrietta Blinder2,3, Lynda Hoey4, Franco Momoli2,3,5, Nicholas Barrowman4,6, Janusz Feber1, Naomi Spitale7, Sherri Lynne Katz8,9. 1. Department of Pediatrics, Division of Nephrology, University of Ottawa, Children's Hospital of Eastern Ontario, 401 Smyth Road, Ottawa, ON, K1H 8L1, Canada. 2. Children's Hospital of Eastern Ontario Research Institute, 401 Smyth Road, Ottawa, ON, K1H 5B2, Canada. 3. School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, 600 Peter Morand Crescent, Ottawa, ON, K1G 5Z3, Canada. 4. Clinical Research Unit, Children's Hospital of Eastern Ontario Research Institute, 401 Smyth Road, Ottawa, ON, K1H 8L1, Canada. 5. Ottawa Hospital Research Institute, 501 Smyth Box 511, Ottawa, ON, K1H 8L6, Canada. 6. Department of Pediatrics, Division of Respiratory Medicine, Children's Hospital of Eastern Ontario, University of Ottawa, 401 Smyth Road, Ottawa, ON, K1H 8L1, Canada. 7. Department of Medicine, University of Ottawa, 451 Smyth Road, Ottawa, ON, K1H 8M5, Canada. 8. Children's Hospital of Eastern Ontario Research Institute, 401 Smyth Road, Ottawa, ON, K1H 5B2, Canada. skatz@cheo.on.ca. 9. Department of Pediatrics, Division of Respiratory Medicine, Children's Hospital of Eastern Ontario, University of Ottawa, 401 Smyth Road, Ottawa, ON, K1H 8L1, Canada. skatz@cheo.on.ca.
Abstract
BACKGROUND: Children with chronic kidney disease (CKD) are at risk for obstructive sleep apnea (OSA) and hypertension. The objectives of this study were to explore associations between OSA severity using the apnea-hypopnea-index(AHI) and obstructive apnea-hypopnea-index(OAHI) on polysomnography (PSG), OSA symptoms, and measures of hypertension in children with CKD. METHODS: One-night in-laboratory PSGs and 24-h ambulatory blood pressure monitoring (ABPM) were performed on children with CKD stages 2-5 (non-dialysis dependent). Sleep questionnaires, including the modified Epworth Sleepiness Scale (ESS) and the Pediatric Sleep Questionnaire (PSQ), were administered during the sleep study. RESULTS: Nineteen children and adolescents completed a PSG and questionnaires and thirteen completed ABPMs. Mean (standard deviation) age at the time of the sleep study was 14.1 (3.2) years. Eleven (58%) participants had CKD stage two, and eight (42%) had stage 3-4. None of the participants were found to have OSA on PSG. One participant had a positive ESS score (≥ 11) and five participants had positive PSQ scores (≥ eight). Night systolic and diastolic pressures were strongly correlated with the OAHI (r = 0.67 and r = 0.69, respectively, p < 0.05), while the AHI was not correlated with any blood pressure measures. CONCLUSIONS: Our study did not find OSA on PSG in children with predominantly mild to moderate CKD. The OAHI was found to be strongly correlated with nighttime blood pressures. Future prospective studies with a larger sample size are needed to monitor for potential progression of symptoms and findings on PSG in pediatric patients as they evolve across the spectrum of CKD.
BACKGROUND:Children with chronic kidney disease (CKD) are at risk for obstructive sleep apnea (OSA) and hypertension. The objectives of this study were to explore associations between OSA severity using the apnea-hypopnea-index(AHI) and obstructive apnea-hypopnea-index(OAHI) on polysomnography (PSG), OSA symptoms, and measures of hypertension in children with CKD. METHODS: One-night in-laboratory PSGs and 24-h ambulatory blood pressure monitoring (ABPM) were performed on children with CKD stages 2-5 (non-dialysis dependent). Sleep questionnaires, including the modified Epworth Sleepiness Scale (ESS) and the Pediatric Sleep Questionnaire (PSQ), were administered during the sleep study. RESULTS: Nineteen children and adolescents completed a PSG and questionnaires and thirteen completed ABPMs. Mean (standard deviation) age at the time of the sleep study was 14.1 (3.2) years. Eleven (58%) participants had CKD stage two, and eight (42%) had stage 3-4. None of the participants were found to have OSA on PSG. One participant had a positive ESS score (≥ 11) and five participants had positive PSQ scores (≥ eight). Night systolic and diastolic pressures were strongly correlated with the OAHI (r = 0.67 and r = 0.69, respectively, p < 0.05), while the AHI was not correlated with any blood pressure measures. CONCLUSIONS: Our study did not find OSA on PSG in children with predominantly mild to moderate CKD. The OAHI was found to be strongly correlated with nighttime blood pressures. Future prospective studies with a larger sample size are needed to monitor for potential progression of symptoms and findings on PSG in pediatric patients as they evolve across the spectrum of CKD.
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Authors: Elaine Urbina; Bruce Alpert; Joseph Flynn; Laura Hayman; Gregory A Harshfield; Marc Jacobson; Larry Mahoney; Brian McCrindle; Michele Mietus-Snyder; Julia Steinberger; Stephen Daniels Journal: Hypertension Date: 2008-08-04 Impact factor: 10.190
Authors: Rosemary S C Horne; Joel S C Yang; Lisa M Walter; Heidi L Richardson; Denise M O'Driscoll; Alison M Foster; Shi Wong; Michelle L Ng; Farhat Bashir; Ruth Patterson; Gillian M Nixon; Damien Jolley; Adrian M Walker; Vicki Anderson; John Trinder; Margot J Davey Journal: Pediatrics Date: 2011-06-27 Impact factor: 7.124
Authors: David D M Nicholl; Sofia B Ahmed; Andrea H S Loewen; Brenda R Hemmelgarn; Darlene Y Sola; Jaime M Beecroft; Tanvir C Turin; Patrick J Hanly Journal: Chest Date: 2012-01-05 Impact factor: 9.410
Authors: Ahmed M El-Refaey; Riad M Elsayed; Amr Sarhan; Ashraf Bakr; Ayman Hammad; Atef Elmougy; Ahmed Y Aboelyazeed Journal: Saudi J Kidney Dis Transpl Date: 2013-07