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Obstructive Sleep Apnea & Heart Risks in Children

Natan Rosenfeld Natan Rosenfeld September 10, 2021

Obstructive sleep apnea (OSA) is on the rise — and not only in adults. Children are becoming increasingly affected by the disorder, likely due to the staggering rise in obesity across the United States. The American Heart Association estimates that up to 6 percent of all children and adolescents suffer from OSA. 


Obstructive sleep apnea can cause symptoms such as habitual snoring, gasping for air during sleep, daytime sleepiness, or a morning headache. But while these symptoms may sound relatively benign, OSA can also have a severe impact on the cardiovascular system, putting sufferers at risk for high blood pressure, abnormal cholesterol levels, and even heart disease.


How OSA affects the heart


Sleep apnea affects the heart through several different pathways. Firstly, the condition is known for causing sleep deprivation. The cardiovascular system needs to rest and recover nightly, so a chronic lack of sleep can cause a multitude of negative cardiovascular effects including heart disease, hypertension and stroke. 


Furthermore, OSA causes abnormal breathing rhythms. Every time a person with OSA wakes up gasping for air, the body’s sympathetic nervous system thinks it’s experiencing a potentially dangerous situation. The nervous system reacts by increasing heart rate, raising blood pressure and constricting blood vessels. All these effects put significant stress on the heart.


When a person with OSA takes a labored breath during sleep, their upper airway is narrowed which causes intrathoracic pressure changes in the chest cavity. Frequent changes in intrathoracic pressure have been linked to a number of heart conditions including atrial fibrillation or even heart failure. 


Lastly, the irregular breathing of an OSA sufferer causes frequent changes in oxygen levels, as they often stop breathing for a period of time, only to take a deep breath moments later. This process leads to something called oxidative stress, which plays a major role in heart disease.


Reducing risk


In order to prevent the development of OSA in children, preventing the development of obesity is an essential first step.


“Obesity is a significant risk factor for sleep disturbances and obstructive sleep apnea, and the severity of sleep apnea may be improved by weight loss interventions, which then improves metabolic syndrome factors such as insulin sensitivity,” said Carissa M. Baker-Smith, M.D., M.P.H., M.S., director of pediatric preventive cardiology at the Nemours Children’s Hospital in Wilmington, Delaware, and associate professor of pediatric cardiology at Sidney Kimmel Medical College at Thomas Jefferson University in Philadelphia.


“We need to increase awareness about how the rising prevalence of obesity may be impacting sleep quality in kids and recognize sleep-disordered breathing as something that could contribute to risks for hypertension and later cardiovascular disease.”

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