Comorbid obstructive sleep apnea and increased risk for sickle cell disease morbidity
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Sickle cell disease (SCD) imparts an increased risk for obstructive sleep apnea (OSA) in childhood. Studies of pediatric SCD have identified an increased risk for pain and neurologic complications with comorbid OSA. We determined the rate of a broad range of SCD-related medical complications to better characterize the spectrum of SCD complications related to OSA.
Retrospective chart review at a single hematology clinic identified 641 youth with SCD who received consistent screenings for OSA as part of routine hematological health maintenance visits over an 11-year period. Medical complication rates in the 136 children with OSA determined by polysomnography exams were compared to 136 matched controls at lower risk for OSA due to negative OSA screenings or exams.
Children with SCD and OSA had higher overall rates of SCD complications than low OSA-risk controls; lung morbidity showed the largest effect size. Infection, cardiovascular, and neurologic complications occurred at higher rates in children with OSA. Children with comorbid OSA had higher rates of SCD complications both before and after OSA diagnosis.
OSA in children with SCD is associated with higher rates of a broad range of SCD complications, including pneumonia and acute chest syndrome. Routine screenings, diagnosis, and increased therapeutic intervention for children with comorbid OSA could decrease SCD morbidity.
KeywordsCell diseases, sickle Apnea, obstructive sleep Sleep-disordered breathing Complications Hospitalization
This project was completed as part of doctoral degree requirements of the first author. No funding was received for this research.
Compliance with ethical standards
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of study, formal consent is not required.
Conflict of interest
The authors declare that they have no conflict of interest.
- 4.Rosen CL, Debaun MR, Strunk RC, Redline S, Seicean S, Craven DI, Gavlak JCD, Wilkey O, Inusa B, Roberts I, Goodpaster RL, Malow B, Rodeghier M, Kirkham FJ (2014) Obstructive sleep apnea and sickle cell anemia. Pediatrics 134(2):273–281. https://doi.org/10.1542/peds.2013-4223 CrossRefPubMedPubMedCentralGoogle Scholar
- 17.Whitesell PL, Owoyemi O, Oneal P, Nouraie M, Klings ES, Rock A, Mellman TA, Berihun T, Lavella J, Taylor RE, Perrine SP (2016) Sleep-disordered breathing and nocturnal hypoxemia in young adults with sickle cell disease. Sleep Med 22:47–49. https://doi.org/10.1016/j.sleep.2016.05.006 CrossRefPubMedPubMedCentralGoogle Scholar
- 26.Narang I, Kadmon G, Lai D, Dhanju S, Kirby-Allen M, Odame I, Amin R, Lu Z, Al-Saleh S (2015) Higher nocturnal and awake oxygen saturations in children with sickle cell disease receiving hydroxyurea therapy. Annals of the American Thoracic Society 12(7):1044–1049. https://doi.org/10.1513/AnnalsATS.201410-473OC CrossRefPubMedGoogle Scholar
- 27.Brietzke SE, Katz ES, Roberson DW (2004) Can history and physical examination reliably diagnose pediatric obstructive sleep apnea/hypopnea syndrome? A systematic review of the literature. Otolaryngol Head Neck Surg 131(6):827–832. https://doi.org/10.1016/j.otohns.2004.07.002 CrossRefPubMedGoogle Scholar