OBSTRUCTIVE SLEEP APNEA SYNDROME IN CHILDREN AS A RISK OF CARDIOVASCULAR PATHOLOGY DEVELOPMENT

Cover Page


Cite item

Full Text

Abstract

Objective: Our aim was to examine the predictors of cardiovascular disorders in children affected by obstructive sleep apnea syndrome (OSAS) based on the results of polysomnography and continuous monitoring of blood glycose. Мethods: Before the examination, parents filled in questionnaires concerning their children sleep quality. The procedure was followed by the study of the sleep by means of polysomnography (Embla s 7000, USA). A system of continuous monitoring of blood glucose was applied (Guardianreal-time, Medtronicminimed, USA) by means of which a glycemic profile tissue fluid was studied. Results: A night sleep research of 120 children aged 3–16 y.o. is presented. There were 4 groups depending on the pathology: diseases of the nervous system (n =31), ENT-pathology (n =18), bronchial asthma (n =24) and overweight and obesity (n =34). The comparison group consisted of 13 apparently healthy children. The study has shown that the parents of every second child with sleep disorders did not know about the fact. The 60 % of the patients with high body mass index (BMI) had a snore, which was significantly higher the in children with normal body mass index — 35% (р =0.012). The index of apnea-hypopnea (AHI) was higher in the patients with ENT-pathology 17 times (p <0.001) and the patients with obesity 7 times (p <0.001) in comparison to the comparison group. In the analysis of the overall sample (n =120) was obtained significant negative correlation with heart rate variability and heart rate (r = 0.405; p <0.001). It is also shown that among 14 investigated children with OSAS only 8 had episodes of hypoglycemia (less than 3.3 mmol/l) during night sleep. All of them were with a high body mass index and with above average stature (>1sd). Conclusion: Children with ENT-pathology and with high high body mass index have high risk of cardio-vascular diseases. Children with above average stature and with increased body mass index affected by OSAS have additional backgrounds for cardiovascular diseases development as a result of the latent periods of hypoglycemia at night.

 

About the authors

O. V. Kozhevnikova

Scientific Centre of Children’s Health, Moscow, Russian Federation

Author for correspondence.
Email: fd@nczd.ru
кандидат медицинских наук, заведующая отделением инструментальной и лабораторной диагностики КДЦ НИИ ППиВЛ Научного центра здоровья детей
Адрес: 119991, Москва, Ломоносовский пр-т, д. 2, стр. 1, тел.: +7 (495) 967-14-20u Россия

L. S. Namazova-Baranova

Scientific Centre of Children’s Health, Moscow, Russian Federation
Sechenov First Moscow State Medical University, Russian Federation
Pirogov Russian National Research Medical University, Moscow, Russian Federation

Email: namazova@nczd.ru

профессор, член-корреспондент РАН, заместитель директора —директор НИИ ППиВЛ Научного центра здоровья детей
Адрес: 119991, Москва, Ломоносовский пр-т, д. 2, стр. 1, тел.: +7 (495) 967-14-20

Россия

E. A. Abashidze

Scientific Centre of Children’s Health, Moscow, Russian Federation

Email: 2803abashidze@mail.ru

кандидат медицинских наук, врач отделения инструментальной и лабораторной диагностики Научного центра здоровья детей
Адрес: 119991, Москва, Ломоносовский пр-т, д. 2, стр. 1, тел.: +7 (495) 967-14-20

Россия

V. V. Altunin

Scientific Centre of Children’s Health, Moscow, Russian Federation

Email: altuninv1@gmail.com
кандидат медицинских наук, врач отделения инструментальной и лабораторной диагностики Научного центра здоровья детей
Адрес: 119991, Москва, Ломоносовский пр-т, д. 2, стр. 1, тел.: +7 (495) 967-14-20 Россия

A. S. Balabanov

Scientific Centre of Children’s Health, Moscow, Russian Federation

Email: a-balabanov@yandex.ru

кандидат социологических наук, научный сотрудник отдела социальной педиатрии Научного центра здоровья детей
Адрес: 119991, Москва, Ломоносовский пр-т, д. 2, стр. 1, тел.: +7 (965) 314-16-33

Россия

I. V. Shirokova

Scientific Centre of Children’s Health, Moscow, Russian Federation

Email: shirokova@nczd.ru

кандидат медицинских наук, врач-эндокринолог клинического отделения Научного центра здоровья детей
Адрес: 119991, Москва, Ломоносовский пр-т, д. 2, стр. 1, тел.: +7 (495) 967-14-20

Россия

I. I. Kondrakhina

Scientific Centre of Children’s Health, Moscow, Russian Federation

Email: fd@nczd.ru
врач-лаборант отделения инструментальной и лабораторной диагностики Научного центра здоровья детей
Адрес: 119991, Москва, Ломоносовский пр-т, д. 2, стр. 1, тел.: +7 (495) 967-14-20

T. A. Polunina

Scientific Centre of Children’s Health, Moscow, Russian Federation

Email: tapolunina@rambler.ru

кандидат медицинских наук, заведующая ОВЛД с болезнями ЛОР-органов и челюстно-лицевой области Научного центра здоровья детей
Адрес: 119991, Москва, Ломоносовский пр-т, д. 2, стр. 1, тел.: +7 (499) 134-08-41

Россия

T. V. Margieva

Scientific Centre of Children’s Health, Moscow, Russian Federation
Sechenov First Moscow State Medical University, Russian Federation

Email: pedpharm@nczd.ru

кандидат медицинских наук, заведующая ОВЛД c нефроурологическими заболеваниями, ожирением и метаболическими болезнями Научного центра здоровья детей
Адрес: 119991, Москва, Ломоносовский пр-т, д. 2, стр. 1, тел.: +7 (499) 132-28-80

References

  1. Baranov A.A. Condition of health of children in the Russian Federation. Pediatriya. Zhurnal im. G.N. Speranskogo = PEDIATRIYA-MOSCOW. 2012; 91 (3): 9–14.
  2. Madaeva I.M., Shevyrtalova O.N., Dolgikh V.V. Arterial hypertension and respiratory disorders during sleep in pediatrics: Results of a pilot study. Sistemnye gipertenzii = Systemic hypertension. 2009; 2: 24.
  3. Kalinkin A.L. Obstructive sleep apnea is a risk factor for hypertension. Arterial'naya gipertenziya = Hypertension. 2003; 2: 37–41.
  4. Kuiyoshi F.H.S., Garsia-Touchard A., Gami A.S., Romero-Corral A., Walt C., Pusalavidyasagar S., Kara T., Caples S.M., Pressman G.S., Vasquez E.C., Lopes-Jimenez F., Somers V.K. Day-night variation of acute myocardial infarction in obstructive sleep apnea. JACC. 2008; 52 (5): 343–346.
  5. Cunningham S.A., Kramer M.R., Venkat Narayan K.M. Incidence of Childhood Obesity in the United States. New Engl. J. Med. 2014; 370 (5): 403–411.
  6. Strueva N.V., Poluektov M.G., Savel'eva L.V., Mel'nichenko G.A. Obesity and sleep. Ozhirenie i metabolism = Obesity and Metabolism. 2013; 3: 11–19.
  7. Mindell J.A., Owens J.A. Pediatric sleep. Diagnosis and management of sleep problems. Philadelphia: Lippincott Williams & Wilkins. 2010. 232 р.
  8. Verhulst S.L., de Backer W. OSA syndrome in children. Eur. Respir. Mon. 2010; 50: 104–120.
  9. Montgomery-Downs H.E., O’Brien L.M., Holbrook R., Gozal D. Snoring and sleep-disordered breathing in young children: subjective and objective correlates. Sleep. 2004; 27 (87): 94.
  10. Kobalava Zh.D. Sovremennye problemy arterial'noi gipertonii. Metabolicheskii sindrom, sovremennye predstavleniya (Modern problems of hypertension. Metabolic syndrome, modern ideas). Available at: http://www.cardiosite.info/articles/article.aspx/articleid=1379 (accessed: 15.11.2014).
  11. Hоi-Hansen T., Pedersen-Bjergaard U., Thorsteinsson B. Reproducibility and reliability of hypoglycaemic episodes recorded with Continuous Glucose Monitoring System (CGMS) in daily life. Diabet Med. 2005; 22 (7): 858–862.
  12. Laptev D.N., Ryabykina G.V. Arrhythmogenic effect of hypoglycemia recorded during prolonged ECG monitoring in children and adolescents with type 1 diabetes. Kardiologiya. Sakharnyi diabet = Cardiology. Diabetes. 2013; 4: 66–71.
  13. Gill G.V., Woodward A., Casson I.F., Weston P.J. Cardiac arrhythmia and nocturnal hypoglycaemia in type 1 diabetes — the ‘dead in bed’ syndrome revisited. Diabetologia. 2009; 52 (1): 42–45.
  14. Inkster B., Riha R.L., Van Look L., Williamson R., McLachlan S., Frier B.M., Strachan M.W., Price J.F., Reynolds R.M. Association between excessive daytime sleepiness and severe hypoglycemia in people with type 2 diabetes: the Edinburgh Type 2 Diabetes Study. Diabetes Care. 2013; 36 (12): 4157–4159.
  15. Wells J., Cole T. Height, adiposity and hormonal cardiovascular risk markers in childhood: how to partition the association? Int. J. Obesity. 2014; 24.
  16. Ljungkrantz M., Ludvigsson J., Samuelsson U. Type 1 diabetes: increased height and weight gains in early childhood. Pediatr. Diabetes. 2008; 9: 50–56.
  17. Capuccio F., Taggart F., Kandala N., Currie A., Peile E., Strangers S., Miller A. Sleep duration predicts cardiovascular outcomes: a systematic review and meta-analysis of prospective studies. UK Sleep. 2008; 31 (5): 619–626.
  18. Abashidze E.A. Otsenka kachestva sna u detei s somaticheskoi patologiei i boleznyami nervnoi sistemy Avtoref. dis. …kand. med. nauk [Assessment of Sleep Quality in Children with Somatic Diseases and Diseases of Nervous System. Author’s abstract]. Moscow, 2012. 25 p.
  19. International classification of sleep disorders, revised. Diagnostic and coding manual. American Sleep Disorders Association. Roch-ester. 1997. 401 p.
  20. American Academy of Sleep Medicine. The AASM manual for the scoring of sleep and associated events: rules, terminology and technical specifications. Version 2.0. 2012. Available at: http://www. aasmnet.org/scoringmanual/default.aspx (accessed: 15.11.2014).
  21. Somers V.K., White D.P., Amin R., Abraham W.T., Costa F., Culerbas F., Daniels S., Floras J.S., Hunt C.E., Olson L.J., Pickering T.G., Russe R., Woo M., Yuoung T. Sleep apnea and cardiovascular disease. JACC. 2008; 52 (8): 686–717.
  22. Muzumdar H.V., Sin S., Nikova M., Gates G., Kim D., Arens R. Changes in heart rate variability after adenotonsillectomy in children with obstructive sleepapnea. Chest. 2011; 139 (5): 1050–1059.
  23. O’Brien L.M., Gozal D. Autonomic dysfunction in children with sleep-disordered breathing. Sleep. 2005; 28 (6): 747–752.

Supplementary files

Supplementary Files
Action
1. JATS XML
Download

Copyright (c) 2015 "Paediatrician" Publishers LLC



This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies