Obstructive sleep apnea syndrome in children: prerequisites for formation and possibilities of ultrasound diagnostics of structural and functional changes in the vascular system

Abstract

Obstructive sleep apnea (OSA) in children are relatively frequent sleep disorder, with a prevalence of 15 %, in pediatrics population, as reported by different studies. The clinical consequences of OSA are daytime sleepiness, cognitive and behavioral disorders, and poor school performance. OSA has serious social implications given their correlations with cardiovascular diseases and obesity. The article reflects the mechanisms involved in the development of the pathologic changes in cardiovascular system in OSA patients, which remain completely unclear, which determines the need for further study of the problem. The role of endothelial dysfunction in children with OSA as the main marker of vascular damage is considered. The description of ultrasound methods for studying the vascular system in OSA pediatric patients is given. The work on the study of cerebral hemodynamics using transcranial duplex scanning of the vessels of the base of the brain and its changes caused by vascular remodeling in OSA are presented. This review discusses the possibility of ultrasound assessment of endothelium-dependent dilatation of the brachial artery in a test with reactive hyperemia as a functional method for diagnosing endothelial dysfunction in OSA children. The use of these methods will make it possible to timely identify the structural and functional changes in blood vessels, which will allow determining the vector of early prevention and pathogenetically substantiate innovative approaches to the treatment of various cardiovascular diseases in OSA children from the standpoint of sleep medicine.