%0 Journal Article
%T The effect of childhood obstructive sleep apnea on ambulatory blood pressure is modulated by the distribution of respiratory events during rapid eye movement and nonrapid eye movement sleep.
%A Au CT
%A Ho CK
%A Wing YK
%A Li AM
%J Sleep Med
%V 14
%N 12
%D Dec 2013
%M 24210606
%F 4.842
%R 10.1016/j.sleep.2013.09.017
%X <B>OBJECTIVE: </B>We aimed to investigate if different childhood obstructive sleep apnea (OSA) subtypes, namely rapid eye movement (REM)-related, nonrapid eye movement (NREM)-related and stage-independent OSA would exert different effects on ambulatory blood pressure (ABP).<BR><B>METHODS: </B>Data from our previous school-based cross-sectional study were reanalyzed. Subjects who had an obstructive apnea-hypopnea index (OAHI) between 1 and 10 events per hour and a total REM sleep duration of >30min were included in our analysis. REM-related and NREM-related OSA were defined as a ratio of OAHI in REM sleep (OAHIREM) to OAHI in NREM sleep (OAHINREM) of >2 and <0.5, respectively. The others were classified as stage-independent OSA.<BR><B>RESULTS: </B>A total of 162 subjects were included in the analysis. In the mild OSA (OAHI, 1-5events/h) subgroup, no significant differences in any ABP parameters were found between OSA subtypes. On the other hand, in subjects with moderate OSA (OAHI, 5-10events/h), the REM-related OSA subtype had a significantly lower daytime systolic blood pressure (SBP) z score (-0.13±0.90 cf 1.15±0.67; P=.012) and nighttime SBP z score (0.29±1.06 cf 1.48±0.88, P=.039) than the stage-independent OSA subtype. Linear regression analyses revealed that OAHINREM but not OAHIREM was significantly associated with both daytime (P=.008) and nighttime SBP (P=.042) after controlling for age, gender, and body size.<BR><B>CONCLUSIONS: </B>Children with obstructive events mainly in REM sleep may have less cardiovascular complications than those with stage-independent OSA.