The Relationship Between Apnea-Hypopnea Index and Hypertension in Pediatric Patients With Obstructive Sleep Apnea

Introduction: Pediatric obstructive sleep apnea (OSA) is an often overlooked problem that can cause negative health and behavioral consequences later in life. OSA is a widely recognized cause of hypertension in adults. However, there have been few studies exploring this relationship in children. In this study, we explore the correlation between pediatric hypertension and OSA.

Methods: This study included 3,673 subjects from the NCH Sleep Database (43.1% female, 8.8 ± 6 years). PyCharm 2021.2.3 was used to extract the apnea-hypopnea index (AHI), diagnostic history, and medication history from 3,984 sleep studies. Patients with a diagnosis of hypertension or dispense history of an anti-hypertensive medication were tagged with hypertension, which was further split into primary and secondary hypertension. Patients with disorders impacting breathing were excluded. The chi square contingency test was used to compare hypertension prevalence among different AHI score groups. Those groups were divided into those who do not meet criteria for OSA (AHI < 1), mild OSA (AHI 1-5), moderate OSA (AHI 5-10), and severe OSA (AHI > 10).

Results: In total, 2,888 patients were included. There were 2,126 patients without OSA, 484 patients with mild OSA, 151 patients with moderate OSA, and 127 patients with severe OSA. Among the groups, there were 12.9%, 14.9%, 17.2%, and 15.7% patients with any hypertension diagnosis, and 4.4%, 7.9%, 13.9%, and 10.2% patients with primary hypertension, respectively. There was no significant difference found between OSA and any hypertension diagnosis, however there was a significant difference found between OSA and primary hypertension (p < 0.0001).

Conclusions: Our results suggest that pediatric OSA is associated with primary hypertension, but is not associated with secondary causes of hypertension.