A new study out of Australia showed that in children with obstructive sleep apnea, their blood pressure levels were higher while awake just before sleep onset and during sleep. Overall, their blood pressure was 10-15 mm Hg higher compared with controls. Blood pressure was elevated, regardless of the severity of sleep apnea. The authors argue that thresholds for mild forms of sleep-disordered breathing needs to be reassessed, and that benign snoring should not be considered benign anymore.
I totally agree with the study authors. Sleep apnea doesn’t begin in middle age—it begins during the early childhood years. Having smaller jaws and more narrow airways predisposes to additional inflammation, causing lymphoid tissues (tonsils and adenoids) to become larger, which causes even more breathing problems. Taking out tonsils and adenoids are usually the first line therapy for most children with sleep apnea, but a significant number of children will have persistent sleep apnea, despite surgery. Since most children undergoing adenotonsillectomy don’t have sleep studies before and after their procedures, we’re probably missing a large number of children with persistent obstructive sleep apnea, despite subjective and clinical improvement in their symptoms.
Addressing these issues early on could potentially prevent many of the complications that may occur later in adulthood. A child that doesn’t sleep well due to breathing problems can manifest with a number of medical conditions, such as ADHD, asthma, developmental delay, bedwetting, ear infections, or even mood disorders. The public health implications are potentially huge.