Shameka Rodgers Phillips, Laura Gray, Ann Hammack Johnson, Sara Davis, Heather Soistmann, Peng Li, Elizabeth Coleman, Thuy Lynch, Marti Rice
{"title":"患有阻塞性睡眠呼吸暂停的学龄儿童血压相关因素","authors":"Shameka Rodgers Phillips, Laura Gray, Ann Hammack Johnson, Sara Davis, Heather Soistmann, Peng Li, Elizabeth Coleman, Thuy Lynch, Marti Rice","doi":"10.1177/01939459251340492","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Children with obstructive sleep apnea (OSA) have an increased risk for high blood pressure (BP). Evidence suggests that arousals, total sleep time (TST), sleep efficiency, oxygen saturation, end-tidal carbon dioxide (ETCO<sub>2</sub>) levels, inflammation, and body mass index (BMI) are associated with changes in BP. Yet, less is known about these relationships in school-aged children with OSA.</p><p><strong>Objective: </strong>This study aimed to determine factors associated with BP in school-aged children with OSA.</p><p><strong>Methods: </strong>A cross-sectional, secondary data analysis of 163 school-aged children (mean age of 7.15 ± 1.16, 62% black, 54.6% female) who participated in the Childhood Adenotonsillectomy Trial.</p><p><strong>Results: </strong>Systolic BP (<i>r</i> = 0.21, <i>p</i> < .01) and diastolic BP (DBP; <i>r</i> = 0.22, <i>p</i> < .01) had a positive relationship with BMI percentiles. The relationship between BMI percentiles and DBP remained when accounting for race and OSA severity (β = 0.19, <i>p</i> = .02). DBP also had a positive relationship with the log percentage of TST with ETCO<sub>2</sub> ≥50 mmHg (<i>r</i> = 0.23, <i>p</i> < .01) that persisted when accounting for BMI percentiles, OSA severity, and race (β = 0.23, <i>p</i> = .004). No other significant relationships were found.</p><p><strong>Conclusions: </strong>Findings suggest that BMI is a main driver of BP in school-aged children with OSA. Also, the percentage of TST with ETCO<sub>2</sub> ≥50 mmHg impacted BP in this sample and further research is needed to explore mechanisms behind these relationships. Clinicians and researchers should advocate for the assessment of all polysomnographic findings when assessing the risk for elevated BP and other comorbidities in children with OSA.</p>","PeriodicalId":49365,"journal":{"name":"Western Journal of Nursing Research","volume":" ","pages":"680-686"},"PeriodicalIF":1.7000,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Factors Associated With Blood Pressure in School-Age Children With Obstructive Sleep Apnea.\",\"authors\":\"Shameka Rodgers Phillips, Laura Gray, Ann Hammack Johnson, Sara Davis, Heather Soistmann, Peng Li, Elizabeth Coleman, Thuy Lynch, Marti Rice\",\"doi\":\"10.1177/01939459251340492\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Children with obstructive sleep apnea (OSA) have an increased risk for high blood pressure (BP). Evidence suggests that arousals, total sleep time (TST), sleep efficiency, oxygen saturation, end-tidal carbon dioxide (ETCO<sub>2</sub>) levels, inflammation, and body mass index (BMI) are associated with changes in BP. Yet, less is known about these relationships in school-aged children with OSA.</p><p><strong>Objective: </strong>This study aimed to determine factors associated with BP in school-aged children with OSA.</p><p><strong>Methods: </strong>A cross-sectional, secondary data analysis of 163 school-aged children (mean age of 7.15 ± 1.16, 62% black, 54.6% female) who participated in the Childhood Adenotonsillectomy Trial.</p><p><strong>Results: </strong>Systolic BP (<i>r</i> = 0.21, <i>p</i> < .01) and diastolic BP (DBP; <i>r</i> = 0.22, <i>p</i> < .01) had a positive relationship with BMI percentiles. The relationship between BMI percentiles and DBP remained when accounting for race and OSA severity (β = 0.19, <i>p</i> = .02). DBP also had a positive relationship with the log percentage of TST with ETCO<sub>2</sub> ≥50 mmHg (<i>r</i> = 0.23, <i>p</i> < .01) that persisted when accounting for BMI percentiles, OSA severity, and race (β = 0.23, <i>p</i> = .004). No other significant relationships were found.</p><p><strong>Conclusions: </strong>Findings suggest that BMI is a main driver of BP in school-aged children with OSA. Also, the percentage of TST with ETCO<sub>2</sub> ≥50 mmHg impacted BP in this sample and further research is needed to explore mechanisms behind these relationships. Clinicians and researchers should advocate for the assessment of all polysomnographic findings when assessing the risk for elevated BP and other comorbidities in children with OSA.</p>\",\"PeriodicalId\":49365,\"journal\":{\"name\":\"Western Journal of Nursing Research\",\"volume\":\" \",\"pages\":\"680-686\"},\"PeriodicalIF\":1.7000,\"publicationDate\":\"2025-08-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Western Journal of Nursing Research\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1177/01939459251340492\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/5/24 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q2\",\"JCRName\":\"NURSING\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Western Journal of Nursing Research","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1177/01939459251340492","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/5/24 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"NURSING","Score":null,"Total":0}
引用次数: 0
摘要
背景：患有阻塞性睡眠呼吸暂停（OSA）的儿童患高血压（BP）的风险增加。有证据表明，觉醒、总睡眠时间（TST）、睡眠效率、氧饱和度、潮末二氧化碳（ETCO2）水平、炎症和体重指数（BMI）与血压变化有关。然而，对患有阻塞性睡眠呼吸暂停症的学龄儿童的这些关系知之甚少。目的：本研究旨在确定学龄期OSA患儿血压的相关因素。方法：对163名参加儿童腺扁桃体切除术试验的学龄儿童（平均年龄7.15±1.16岁，黑人62%，女性54.6%）进行横断面、二次资料分析。结果:收缩压(r = 0.21, p r = 0.22, p p = .02点)。当ETCO2≥50 mmHg时，DBP与TST对数百分比呈正相关（r = 0.23, p = 0.004）。没有发现其他重要的关系。结论：研究结果提示BMI是学龄期OSA患儿BP的主要驱动因素。此外，该样本中ETCO2≥50 mmHg的TST百分比影响血压，需要进一步研究探索这些关系背后的机制。临床医生和研究人员在评估OSA患儿血压升高和其他合并症的风险时，应提倡对所有多导睡眠图结果进行评估。
Factors Associated With Blood Pressure in School-Age Children With Obstructive Sleep Apnea.
Background: Children with obstructive sleep apnea (OSA) have an increased risk for high blood pressure (BP). Evidence suggests that arousals, total sleep time (TST), sleep efficiency, oxygen saturation, end-tidal carbon dioxide (ETCO2) levels, inflammation, and body mass index (BMI) are associated with changes in BP. Yet, less is known about these relationships in school-aged children with OSA.
Objective: This study aimed to determine factors associated with BP in school-aged children with OSA.
Methods: A cross-sectional, secondary data analysis of 163 school-aged children (mean age of 7.15 ± 1.16, 62% black, 54.6% female) who participated in the Childhood Adenotonsillectomy Trial.
Results: Systolic BP (r = 0.21, p < .01) and diastolic BP (DBP; r = 0.22, p < .01) had a positive relationship with BMI percentiles. The relationship between BMI percentiles and DBP remained when accounting for race and OSA severity (β = 0.19, p = .02). DBP also had a positive relationship with the log percentage of TST with ETCO2 ≥50 mmHg (r = 0.23, p < .01) that persisted when accounting for BMI percentiles, OSA severity, and race (β = 0.23, p = .004). No other significant relationships were found.
Conclusions: Findings suggest that BMI is a main driver of BP in school-aged children with OSA. Also, the percentage of TST with ETCO2 ≥50 mmHg impacted BP in this sample and further research is needed to explore mechanisms behind these relationships. Clinicians and researchers should advocate for the assessment of all polysomnographic findings when assessing the risk for elevated BP and other comorbidities in children with OSA.
期刊介绍：
Western Journal of Nursing Research (WJNR) is a widely read and respected peer-reviewed journal published twelve times a year providing an innovative forum for nurse researchers, students, and clinical practitioners to participate in ongoing scholarly dialogue. WJNR publishes research reports, systematic reviews, methodology papers, and invited special papers. This journal is a member of the Committee on Publication Ethics (COPE).
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
