Sleep Apnea Causes High Blood Pressure In Children

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.











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8 thoughts on “Sleep Apnea Causes High Blood Pressure In Children

  1. But what treatments are there for these kids, especially if you believe it to be the structure of their mouths and nasal passages? CPAP? I would have never done it as a kid, even now as an adult I don’t think I could. What else is there?

    I think my problem is histamines as only anti histamines so far have helped aleviate the nightly congestion. But I can’t do those continuously. So something else must be going on as I have been tested for allergies and none show up.

    I really hope that more studies are done on sleep apnea as it seems the solutions aren’t really all that great right now. Unfortuneatly it’s the drug companies who can afford the studies and we don’t need more drugs.

  2. I am wondering why it has never been routine to also remove the lingual tonsil. if tongue collapse is one of the biggest problems in SDB, wouldn’t it make sense to reduce the base of the tongue by removing the lingual tonsil? why is this not done? it seems like a disconnect.

  3. Dr. Deb,

    Lingual tonsillectomy is not routinely done because it’s not usually visualized on a routine pediatric ENT exam. Not all children with large palatine tonsils have it. I’ve been recommending it for children and adults, especially if their lingual tonsils are very large.

  4. Besides allergies, most people with sleep apnea also have nonallergic or chronic rhinitis. Allergy meds work sometimes, but not as well as for routine allergies. Some people need to go onto surgical options for nasal congestion. Unfortunately, there’s no magic bullet for sleep apnea. There will always be various different options, from very conservative to very aggressive.

  5. ahhhh…. the typical problem in medicine. if you can’t see it, it doesn’t exist!
    and out of sight out of mind. you would think an ENT doc would think of it, however. at least enough to look and consider. I know you do that, but I had to specifically request a fiberoptic exam for my son. most people wouldn’t know to do that.

  6. my son has what we think is sleep apnea has 7 episodes an hour ,he also has very high blood presure and kidney problems ,he is very active during the day not overweight at all abit on the thin slde if anything ,they want to remove his tonsils but on examination they were found to be very small for his age ,he is 4,its taken nearly 2 years for anyone to believe me about what happens to him ,its even taken over 30 sec to make him breath again sometimes.i feel that im just passed from one person to the next im not a paranoid mum[ he is one of 4] just a very worried one .any advice from anyone would help

  7. Beverly, you can have very small tonsils and still have significant obstructive sleep apnea. This is because, obstruction can occur in the nose, soft palate, and/or the tongue base. Ultimately, it’s due to upper and lower jaw underdevelopment and dental crowding, which narrows the upper airways.