{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,9]],"date-time":"2026-04-09T04:50:28Z","timestamp":1775710228183,"version":"3.50.1"},"reference-count":32,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2025,4,1]],"date-time":"2025-04-01T00:00:00Z","timestamp":1743465600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R01HL070907"],"award-info":[{"award-number":["R01HL070907"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R01HL080670"],"award-info":[{"award-number":["R01HL080670"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Sleep Research"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    Obstructive sleep apnea (OSA) in children alters circadian blood pressure (BP) rhythms. We hypothesised that circadian BP dysregulation in paediatric OSA is associated with structural and functional cardiac changes. This was a single\u2010centre, cross\u2010sectional, observational study of children 5\u201314\u2009years with OSA and healthy controls. Participants underwent polysomnography, 24\u2010h ambulatory BP monitoring, and echocardiography. Circadian BP parameters included times arrived at BP and BP velocity peaks and nadirs, and nocturnal BP dipping. Regression and mediation analyses assessed the relationship between circadian BP parameters and cardiac structure and function. There were 100 children with OSA and 94 controls enrolled with mean\u2009\u00b1\u2009SD obstructive apnea hypopnea index (OAHI) of 8.2\u2009\u00b1\u20099.0 and 0.3\u2009\u00b1\u20090.3 respectively. Earlier diastolic BP and BP velocity peaks were associated with decreased left ventricular relaxation (\n                    <jats:italic>e<\/jats:italic>\n                    \u2032 velocity) and increased left atrial pressure (\n                    <jats:italic>E<\/jats:italic>\n                    \/\n                    <jats:italic>e<\/jats:italic>\n                    \u2032 ratio). Diastolic nocturnal dipping was greater in controls than in the OSA group. Lower nocturnal dipping was also associated with decreased left ventricular relaxation and increased left atrial pressure. Systolic BP dipping was negatively associated with isovolumetric relaxation time. OAHI was a significant covariate in many models. Diastolic nocturnal dipping was a significant mediator in the associations between OAHI and left ventricular relaxation. Circadian BP parameters were not significantly associated with pulmonary artery pressure or cardiac geometry. Shifts in circadian BP parameters and reduced BP dipping were associated with diastolic dysfunction in children; OSA severity influenced many associations highlighting the relevance of OSA severity to cardiac function.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Trial Registration:<\/jats:bold>\n                    <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"http:\/\/clinicaltrials.gov\">ClinicalTrials.gov<\/jats:ext-link>\n                    identifier: NCT00059111, NCT01837459\n                  <\/jats:p>","DOI":"10.1111\/jsr.70049","type":"journal-article","created":{"date-parts":[[2025,4,3]],"date-time":"2025-04-03T16:59:08Z","timestamp":1743699548000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Relationship of Circadian Blood Pressure Dysregulation With Left Ventricular Structure and Function in Children With Obstructive Sleep Apnea"],"prefix":"10.1111","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3438-4199","authenticated-orcid":false,"given":"Abigail M.","family":"Witter","sequence":"first","affiliation":[{"name":"University of Cincinnati College of Medicine  Cincinnati Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David F.","family":"Smith","sequence":"additional","affiliation":[{"name":"Division of Pediatric Otolaryngology\u2010Head and Neck Surgery Cincinnati Children's Hospital Medical Center  Cincinnati Ohio USA"},{"name":"Division of Pulmonary Medicine and the Sleep Center Cincinnati Children's Hospital Medical Center  Cincinnati Ohio USA"},{"name":"The Center for Circadian Medicine Cincinnati Children's Hospital Medical Center  Cincinnati Ohio USA"},{"name":"Department of Otolaryngology\u2013Head and Neck Surgery University of Cincinnati College of Medicine  Cincinnati Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Md Tareq Ferdous","family":"Khan","sequence":"additional","affiliation":[{"name":"Department of Public Health Sciences Clemson University  Clemson South Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aisaku","family":"Nakamura","sequence":"additional","affiliation":[{"name":"Division of Biostatistics and Epidemiology Cincinnati Children's Hospital Medical Center  Cincinnati Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9329-9459","authenticated-orcid":false,"given":"Christine L.","family":"Schuler","sequence":"additional","affiliation":[{"name":"Division of Pulmonary Medicine and the Sleep Center Cincinnati Children's Hospital Medical Center  Cincinnati Ohio USA"},{"name":"Division of Hospital Medicine Cincinnati Children's Hospital Medical Center  Cincinnati Ohio USA"},{"name":"Department of Pediatrics University of Cincinnati College of Medicine  Cincinnati Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8002-0332","authenticated-orcid":false,"given":"Mark W.","family":"DiFrancesco","sequence":"additional","affiliation":[{"name":"The Imaging Research Center, Department of Radiology Cincinnati Children's Hospital Medical Center  Cincinnati Ohio USA"},{"name":"Department of Radiology University of Cincinnati College of Medicine  Cincinnati Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Md Monir","family":"Hossain","sequence":"additional","affiliation":[{"name":"Division of Pulmonary Medicine and the Sleep Center Cincinnati Children's Hospital Medical Center  Cincinnati Ohio USA"},{"name":"Division of Biostatistics and Epidemiology Cincinnati Children's Hospital Medical Center  Cincinnati Ohio USA"},{"name":"Division of Biostatistics and Bioinformatics, Department of Environmental and Public Health Sciences University of Cincinnati College of Medicine  Cincinnati Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Raouf S.","family":"Amin","sequence":"additional","affiliation":[{"name":"Division of Pulmonary Medicine and the Sleep Center Cincinnati Children's Hospital Medical Center  Cincinnati Ohio USA"},{"name":"Department of Pediatrics University of Cincinnati College of Medicine  Cincinnati Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,4]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm.153.2.8564147"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.107.099762"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.200309\u20101305OC"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2004.11.044"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12929\u2010020\u201000658\u20107"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cger.2021.04.006"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2020.11.019"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamacardio.2021.2003"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40675\u2010017\u20100071\u20106"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.congress\u20102015.OA298"},{"issue":"14","key":"e_1_2_11_12_1","first-page":"1932","article-title":"Glucose and Arterial Blood Pressure Variability in Obstructive Sleep Apnea Syndrome","volume":"17","author":"Kallianos A.","year":"2013","journal-title":"European Review for Medical and Pharmacological Sciences"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1093\/sleep\/zsad254"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.200912\u20101845OC"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1093\/sleep\/19.suppl9.s61"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/pchj.252"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.3390\/diagnostics11061082"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00408\u2010021\u201000426\u2010w"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1080\/08037051.2019.1615369"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.1914112117"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2012\u20101671"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.5664\/jcsm.6664"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2016.01.011"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.1152\/ajpcell.00305.2020"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.sleep.2010.09.015"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cub.2016.04.011"},{"key":"e_1_2_11_27_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10072\u2010021\u201005765\u20103"},{"key":"e_1_2_11_28_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11886\u2010020\u20101257\u2010y"},{"key":"e_1_2_11_29_1","doi-asserted-by":"publisher","DOI":"10.2174\/157016111203140518173019"},{"key":"e_1_2_11_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.chest.2019.02.011"},{"key":"e_1_2_11_31_1","doi-asserted-by":"publisher","DOI":"10.1177\/0300060513516756"},{"key":"e_1_2_11_32_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2012.02.041"},{"key":"e_1_2_11_33_1","doi-asserted-by":"publisher","DOI":"10.7554\/eLife.63003"}],"container-title":["Journal of Sleep Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jsr.70049","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,1]],"date-time":"2025-12-01T13:57:39Z","timestamp":1764597459000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jsr.70049"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4]]},"references-count":32,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2025,10]]}},"alternative-id":["10.1111\/jsr.70049"],"URL":"https:\/\/doi.org\/10.1111\/jsr.70049","archive":["Portico"],"relation":{},"ISSN":["0962-1105","1365-2869"],"issn-type":[{"value":"0962-1105","type":"print"},{"value":"1365-2869","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,4]]},"assertion":[{"value":"2024-11-05","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-03-12","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-04-01","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70049"}}