Blood pressure regulation, autonomic control and sleep disordered breathing in children

Nisbet, Lauren; Yiallourou, Stephanie; Walter, Lisa M.; Horne, Rosemary Sylvia Claire

doi:10.1016/j.smrv.2013.04.006

Cited by 85 publications

(50 citation statements)

References 90 publications

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“…This is consistent with our previous findings (11), and others related to SDB and blood pressure in children (10, 12, 13). …”

Section: Discussionsupporting

confidence: 94%

“…In particular, short sleep duration has been linked to weight gain and greater risk of obesity, (2–5) and hypertension (6–9). Sleep disordered breathing (SDB) in children also has been implicated as a factor in elevations in blood pressure (10–13). Therefore, it is unclear whether sleep duration and SDB are independent risk factors for this condition.…”

Section: Introductionmentioning

confidence: 99%

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Impact of sleep duration and weekend oversleep on body weight and blood pressure in adolescents

Quan

Combs

Parthasarathy

2018

Southwest J Pulm Crit Care

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Introduction Weekend oversleep or catchup sleep is a frequent occurrence in children, but there are relatively little data concerning its impact on weight and blood pressure. The aim of this study was to assess the association between sleep duration and oversleep, and weight and blood pressure in adolescents. Methods Sleep duration, weight and blood pressure of 327 children (51.4% boys, mean age 13.3 ± 1.7 years) who had polysomnograms performed during both exam cycles of the Tucson Children’s Assessment of Sleep Apnea study (TuCASA) were analyzed. Sleep duration on school nights and non-school nights was used to compute a weighted average of child and parent reported overall sleep duration respectively. Oversleep was defined as the difference between self and parent reported weekend sleep and weekday sleep separately. Simple correlations between overall sleep duration, sleep on school and non-school nights and oversleep, and blood pressure, standardized body mass index (BMI), snoring, respiratory disturbance index (RDI) and age were calculated. Significant bivariate associations then were used to develop multivariate partial correlation models. Results Unadjusted negative correlations with BMI were noted for parent reported total sleep duration at the 1st exam cycle, parent and child reported total sleep and school night sleep duration, and parent reported non-school night sleep duration at the 2nd exam cycle. Additionally, for BMI, positive correlations were observed for log RDI at both exam cycles and snoring at the 2nd exam cycle. For blood pressure, there were positive associations with age, parent reported oversleep, caffeine consumption and snoring. Additionally, for blood pressure, negative relationships were observed with parent reported total sleep duration at the 1st exam cycle, and parent and child reported total sleep and school night sleep durations at the 2nd exam cycle. Partial correlations found that BMI was negatively correlated with parent reported total sleep duration at the 1st exam cycle and parent reported total sleep duration at the 2nd exam cycle, and positively correlated with snoring and log RDI at both exam cycles. Systolic blood pressure was only associated with age and snoring. Diastolic blood pressure was positively correlated with age and caffeine consumption, and negatively correlated with parent reported total and school night sleep duration. Oversleep and child reported sleep duration were not represented in any of these models. Conclusion Lower amounts of sleep especially on school nights is associated with higher body weight and blood pressure. Oversleep was not associated with either body weight or blood pressure.

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“…This is consistent with our previous findings (11), and others related to SDB and blood pressure in children (10, 12, 13). …”

Section: Discussionsupporting

confidence: 94%

Section: Introductionmentioning

confidence: 99%

Impact of sleep duration and weekend oversleep on body weight and blood pressure in adolescents

Quan

Combs

Parthasarathy

2018

Southwest J Pulm Crit Care

View full text Add to dashboard Cite

show abstract

“…Rather, ultradian blood pressure dipping appears to reflect varying underlying physiological processes, such as those seen across the sleep/wake cycle[6, 34, 35]. In fact, several lines of evidence suggest that the dipping pattern seen in prairie voles during the inactive period likely occurs during sleep.…”

Section: Discussionmentioning

confidence: 99%

Male prairie voles display cardiovascular dipping associated with an ultradian activity cycle

Lewis

Curtis

2016

Physiology & Behavior

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Mammals typically display alternating active and resting phases and, in most species, these rhythms follow a circadian pattern. The active and resting phases often are accompanied by corresponding physiological changes. In humans, blood pressure decreases during the resting phase of the activity cycle, and the magnitude of that “nocturnal dipping” has been used to stratify patients according to the risk for cardiovascular disease. However, in contrast to most mammals, prairie voles (Microtus ochrogaster) have periods of activity and rest that follow an ultradian rhythm with period lengths significantly less than 24h. While rhythmic changes in blood pressure across a circadian activity cycle have been well-documented, blood pressure patterns in species that display ultradian rhythms in activity is less well-studied. In the current study, we implanted pressure-sensitive radiotelemetry devices in male prairie voles and recorded activity, mean arterial pressure (MAP), and heart rate (HR) continuously for 3 days. Visualization of the ultradian rhythms was enhanced using a 1hr running average to filter the dataset. Positive correlations were found between activity and MAP and between activity and HR. During the inactive period of the ultradian cycle, blood pressure decreased by about 15%, which parallels the nocturnal dipping pattern seen in healthy humans. Further, the duration of inactivity did not affect any of the cardiovascular measures, so the differences in blood pressure values between the active and inactive periods are likely driven by ultradian oscillations in hormones and autonomic function. Finally, specific behavioral patterns also were examined. Both the instrumented animal and his non-instrumented cagemate appeared to show synchronized activity patterns, with both animals displaying sleep-like behavior for more than 90% of the inactive period. We propose that the prairie vole ultradian rhythm in blood pressure is an analogue for circadian blood pressure variability and can be used to study the long-term effects of commonly prescribed drugs on blood pressure dipping.

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“…It is possible that factors which cause high BP in children and adolescents, such as renal parenchymal disease 23 , or risk factors for high BP such as sleep disordered breathing 24 or early infections 25 , reduced over the period. The introduction of universal neonatal immunization for hepatitis B in Hong Kong in 1988 26 , or better access to care with the introduction of the Hospital Authority in Hong Kong in 1990 27 could perhaps play a role, but leaves the lack of fall in the upper tail of the systolic BP distribution in boys aged 12 years or older unexplained.…”

Section: Discussionmentioning

confidence: 99%

Divergent secular trends in blood pressure and body mass index in children and adolescents in Hong Kong

Kwok

Leung

Chung

et al. 2017

Sci Rep

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Secular trends in blood pressure (BP) and body mass index (BMI) during childhood and adolescence are sentinels for the future population cardiovascular disease burden. We examined trends in BP z-score (ages 9–18 years from 1999 to 2014) and BMI z-score (ages 6–18 years from 1996 to 2014) in Hong Kong, China. Overall, BP z-score fell, systolic BP from 0.08 to −0.01 in girls and from 0.31 to 0.25 in boys. However, the trends were not consistent, for both sexes, systolic BP z-score was stable from 1999, decreased slightly from 2002 to 2005 and increased slightly to 2014, diastolic BP z-score decreased slightly from 1999 to 2004 and then remained stable to 2014. In contrast, BMI z-score rose from −0.15 to −0.01 in girls and from 0.14 to 0.34 in boys, mainly during 1997 to 2010. The upper tail of the systolic (except boys) and diastolic BP distribution shifted downwards, whereas the entire BMI distribution shifted upward. BP declined slightly whereas BMI rose in Hong Kong children and adolescents during the last 20 years, with systolic BP and BMI in boys above the reference. This warrants dual action in tackling rising BMI and identifying favorable determinants of BP, particularly targeting boys.

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Blood pressure regulation, autonomic control and sleep disordered breathing in children

Cited by 85 publications

References 90 publications

Impact of sleep duration and weekend oversleep on body weight and blood pressure in adolescents

Impact of sleep duration and weekend oversleep on body weight and blood pressure in adolescents

Male prairie voles display cardiovascular dipping associated with an ultradian activity cycle

Divergent secular trends in blood pressure and body mass index in children and adolescents in Hong Kong

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