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This study evaluated 4 mixed-effects cosinor models by applying them to systolic and diastolic blood pressure (SBP and DBP) data collected from children with obstructive sleep apnea (OSA) and healthy controls (non-OSA) and compared the estimated circadian parameters between groups. The analysis included 24-h BP monitoring data from 219 age- and gender-matched children (117 controls, 52 with mild OSA, and 50 with moderate-to-severe OSA [MS-OSA]). Mixed-effects cosinor models with 1 to 4 components estimated various circadian parameters: acrophase, amplitude, and time arrived at peak velocity (TAPV). The 3-component mixed-effects cosinor model provided the best fit for SBP and DBP data. The estimated MESOR (midline estimating statistic of rhythm) was 106\u2009mmHg for SBP and 64\u2009mmHg for DBP in the control group; the MS-OSA group had a higher DBP MESOR (66\u2009mmHg). Children with OSA had a dampened early afternoon BP peak and an increased late-evening BP peak. The timing differences for the first BP peak were more pronounced in the morning for SBP, and from morning to mid-day for DBP, particularly in MS-OSA. TAPV occurred in the morning in all models, with slight timing differences in SBP for mild OSA, and in DBP for MS-OSA, compared to controls. Although single-component cosinor models are traditionally used for 24-h BP rhythms, the multi-component mixed-effects models provided a better fit and captured disease-related differences.<\/jats:p>","DOI":"10.1177\/07487304261459486","type":"journal-article","created":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T12:14:10Z","timestamp":1783080850000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Modeling 24-Hour Blood Pressure Rhythms Using Mixed-Effects Cosinor Models"],"prefix":"10.1177","author":[{"given":"Md Tareq Ferdous","family":"Khan","sequence":"first","affiliation":[{"name":"Department of Public Health Sciences, Clemson University, SC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0048-4012","authenticated-orcid":false,"given":"David F.","family":"Smith","sequence":"additional","affiliation":[{"name":"Division of Pediatric Otolaryngology-Head and Neck Surgery, Cincinnati Children\u2019s Hospital Medical Center, OH, USA"},{"name":"Division of Pulmonary Medicine, Cincinnati Children\u2019s Hospital Medical Center, OH, USA"},{"name":"The Sleep Center, Cincinnati Children\u2019s Hospital Medical Center, OH, USA"},{"name":"The Center for Circadian Medicine, Cincinnati Children\u2019s Hospital Medical Center, OH, USA"},{"name":"Department of Otolaryngology-Head and Neck Surgery, University of Cincinnati College of Medicine, OH, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine L.","family":"Schuler","sequence":"additional","affiliation":[{"name":"Division of Hospital Medicine, Cincinnati Children\u2019s Hospital Medical Center, OH, USA"},{"name":"Department of Pediatrics, University of Cincinnati College of Medicine, OH, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark W.","family":"DiFrancesco","sequence":"additional","affiliation":[{"name":"The Imaging Research Center, Department of Radiology, Cincinnati Children\u2019s Hospital Medical Center, OH, USA"},{"name":"Department of Radiology, University of Cincinnati College of Medicine, OH, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marc D.","family":"Ruben","sequence":"additional","affiliation":[{"name":"Division of Pulmonary Medicine, Cincinnati Children\u2019s Hospital Medical Center, OH, USA"},{"name":"Department of Pediatrics, University of Cincinnati College of Medicine, OH, USA"},{"name":"Division of Biomedical Informatics, Cincinnati Children\u2019s Hospital Medical Center, OH, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marepalli B.","family":"Rao","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, Health Informatics and Data Sciences, University of Cincinnati College of Medicine, OH, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raouf S.","family":"Amin","sequence":"additional","affiliation":[{"name":"Division of Pulmonary Medicine, Cincinnati Children\u2019s Hospital Medical Center, OH, USA"},{"name":"The Sleep Center, Cincinnati Children\u2019s Hospital Medical Center, OH, USA"},{"name":"Department of Pediatrics, University of Cincinnati College of Medicine, OH, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0064-3658","authenticated-orcid":false,"given":"Md Monir","family":"Hossain","sequence":"additional","affiliation":[{"name":"Division of Pulmonary Medicine, Cincinnati Children\u2019s Hospital Medical Center, OH, USA"},{"name":"Department of Pediatrics, University of Cincinnati College of Medicine, OH, USA"},{"name":"Division of Biostatistics and Epidemiology, Cincinnati Children\u2019s Hospital Medical Center, OH, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,7,3]]},"reference":[{"key":"e_1_3_3_2_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0124050"},{"key":"e_1_3_3_3_1","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.107.099762"},{"key":"e_1_3_3_4_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.200309-1305OC"},{"key":"e_1_3_3_5_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.HYP.30.3.603"},{"key":"e_1_3_3_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/sleep\/32.6.731"},{"key":"e_1_3_3_7_1","article-title":"A method for characterizing daily physiology from widely used wearables","volume":"1","author":"Bowman C","year":"2021","unstructured":"Bowman C, Huang Y, Walch OJ, Fang Y, Frank E, Tyler J, Mayer C, Stockbridge C, Goldstein C, Sen S, et al. 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