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Updated: May 17, 2026
Multi-Modal Home Sleep Monitoring in Older Adults
Published on: January 26, 2019
Stability of polysomnography for one year and longer in children with sickle cell disease
Jonathan E Mullin1, Benjamin P Cooper, Fenella J Kirkham
1Case Western Reserve University School of Medicine, Cleveland, OH, USA.
Insights
Polysomnography (PSG) results for children with sickle cell disease (SCD) are generally stable over time when no acute complications occur. Most children did not show changes in sleep disordered breathing (SDB) that would alter their diagnosis between tests.
Area of Science:
- Pediatric Pulmonology
- Hematology
- Sleep Medicine
Background:
- Sleep disordered breathing (SDB) is a potential concern for children with sickle cell disease (SCD).
- The stability of SDB diagnosis in this population requires further investigation, particularly in stable disease states.
Purpose of the Study:
- To assess the stability of polysomnography (PSG) findings in children with SCD who are not experiencing acute complications.
- To determine if SDB status changes significantly over a 12- to 30-month period in this cohort.
Main Methods:
- A subsample of 63 children (4-18 years) with Hb SS or HbSβ(0) SCD underwent two PSG tests.
- Forty-five children were included in the stability analysis, excluding those with recent transfusions, hydroxyurea treatment, adenotonsillectomy, or acute SCD complications.
- SDB was defined by apnea-hypopnea index (AHI) thresholds of ≥ 2 or ≥ 5 events per hour.
Main Results:
- The interval between PSGs was approximately 19 months.
- For the AHI ≥ 2 threshold, 10 of 45 children improved (≥ 2 to < 2), and 3 of 45 worsened (< 2 to ≥ 2).
- For the AHI ≥ 5 threshold, 6 of 45 children improved (≥ 5 to < 5), and 2 of 45 worsened (< 5 to ≥ 5).
Conclusions:
- Overnight PSG results for SDB in children with SCD tend to be stable or improve over 12–30 months when acute complications are absent.
- A small proportion (≤ 6.7%) of children experienced a change in SDB classification between the two PSG tests.
Study Objectives:
Serious morbidity may be linked to sleep disordered breathing (SDB) among children with sickle cell disease (SCD). We investigated the stability of polysomnography (PSG) results among children not having acute complications of SCD.
Methods:
Two PSGs were performed on a subsample of 63 children 4 to 18 years of age from the Sleep and Asthma Cohort Study. All had Hb SS or HbSβ(0) disease. Two PSGs were compared for 45 subjects. Excluded from comparison were 18 children who had begun transfusions or hydroxyurea, had an adenotonsillectomy between the PSGs, or had a pain crisis or the acute chest syndrome within 3 months of the second PSG. Sleep disordered breathing was identified using 2 thresholds for the apnea hypopnea index (AHI): ≥ 2 or ≥ 5 respiratory events per hour.
Results:
Ages were 12.3 yrs ± 4.0, BMI, 18.2 ± 3.2. Interval between PSGs was 581 ± 119 days (19.1 ± 3.9 months). Ten of 45 changed from ≥ 2 events per hour to < 2; 3 of 45 from < 2 to ≥ 2; 7 of 45 had ≥ 2 on both nights. Six of 45 changed from ≥ 5 to < 5, 2 of 45 from < 5 to ≥ 5, and 1 had ≥ 5 on both nights (McNemar χ(2), p = 0.09, and p = 0.29).
Conclusions:
In the absence of acute SCD complications, overnight PSG usually remains stable or improves over a 12- to 30-month period. Only 6.7% subjects, or fewer, had AHI on a subsequent PSG that would re-classify the child as having SDB not identified in the earlier PSG.
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