ArticlePediatric research2026
Hypoxic burden as a cause of cardiovascular morbidity in childhood obstructive sleep apnea.
Article in Pediatric research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- Association of Presystolic Wave with Subclinical Left Ventricular Dysfunction in Obstructive Sleep Apnea Syndrome.Echocardiography (Mount Kisco, N.Y.) · 2026Article
- Pulse oximetry in infants with Robin sequence.European journal of pediatrics · 2026Article
- Hypoxic Burden in Children With Sleep-Disordered Breathing: Determinants and Correlates.Journal of sleep research · 2026Article
- Polysomnographic versus parent-reported predictors of executive function in children with sleep disordered breathing.International journal of pediatric otorhinolaryngology · 2026Article
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Authors and funding
3 authors.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundTo assess whether hypoxic burden (HB) is associated with cardiac autonomic nervous system dysfunction and increased blood pressure (BP) in otherwise healthy children with moderate to severe obstructive sleep apnea (OSA).
methodsAmong 103 children with moderate-to-severe OSA, twenty pairs, matched for age, sex and obstructive apnea-hypopnea index (OAHI) were selected, with low (first quartile) or high (fourth quartile) HB in each pair: median [25th-75th percentiles]; age: 10.8 years [7.3; 13.2] vs. 11.4 [8.6; 13.5]; sex: 7 and 10 girls; z-score of body mass index: 1.50 [0.11; 2.43] vs. 2.40 [1.92; 2.70] (p = 0.012); OAHI: 8.6/hr [6.4; 13.3] vs. 11.1 [6.6; 17.2] and HB: 0.8%.min/h [0.3; 1.5] vs. 13.8 [10.1; 22.3], respectively.
resultsNon-linear heart rate variability (HRV) indices obtained from polysomnography showed sympathetic overflow (Poincaré plot: decreased SD2) and weaker parasympathetic modulation (decreased SD1) in children with high versus low HB. The high versus low HB group had higher percentiles of office BP: systolic, 75th [61; 81] vs. 57th [47; 69], p = 0.049 and diastolic, 70th [60; 78] vs. 55th [46; 65], p = 0.007, adjusted for obesity and arousal index.
conclusionsDespite similar levels of OAHI, children with higher HB demonstrate parasympathetic withdrawal and increased daytime blood pressure. IMPACT: The hypoxic burden predicts cardiovascular morbidity/mortality in adult obstructive sleep apnea syndrome. Our study shows that in children with moderate to severe obstructive sleep apnea, despite similar levels of obstructive apnea-hypopnea index, those with higher hypoxic burden show cardiac autonomic nervous system dysfunction and increased daytime blood pressure. This study is the first one suggesting that the hypoxic burden is a valuable marker of cardiovascular morbidity in childhood obstructive sleep apnea.
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