Childhood sleep‐disordered breathing and its implications for cardiac and vascular diseases

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Abstract
Objective: To systematically evaluate the recent literature regarding the relationship between childhood sleep‐disordered breathing (SDB)/obstructive sleep apnoea (OSA) and cardiovascular diseases in children. Methods: The literature about SDB/OSA and blood pressure, sympathetic activation, arterial distensibility, ventricular hypertrophy and insulin resistance were studied. Meta‐analysis of risk of hypertension and high apnoea–hyponoea index were performed to calculate the combined odds ratio and it is equal to 2.93 (95% CI = 1.18–7.29). Results: The results suggest a significant association between SDB/OSA and hypertension. However, the data are not adequate to draw firm conclusion although evidences were emerging to suggest that SDB/OSA affects blood pressure in either directions in children. Limited evidences also suggest that SDB/OSA is associated with increased sympathetic activation, decreased arterial distensibility and ventricular hypertrophy. Conclusions: There is now increasing but not adequate evidence that childhood SDB/OSA is associated with detectable cardiovascular abnormalities.