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Obstructive sleep apnea and sickle cell anemia

Carol L Rosen1, Michael R Debaun2, Robert C Strunk3

  • 1Department of Pediatrics and Rainbow Babies and Children's Hospital, Case Western Reserve University School of Medicine, Cleveland, Ohio; carol.rosen@case.edu.

Pediatrics
|July 16, 2014
PubMed

Insights

Obstructive sleep apnea syndrome (OSAS) is common in children with sickle cell anemia (SCA). Habitual snoring and low oxygen saturation are key risk factors, necessitating increased screening and treatment in this population.

Area of Science:

  • Pediatric Hematology
  • Sleep Medicine
  • Pulmonology

Background:

  • Sickle cell anemia (SCA) is a genetic blood disorder with significant morbidity.
  • Sleep-disordered breathing, including obstructive sleep apnea syndrome (OSAS), is increasingly recognized in pediatric populations.
  • The prevalence and specific risk factors for OSAS in children with SCA are not well-established.

Purpose of the Study:

  • To determine the prevalence of obstructive sleep apnea syndrome (OSAS) in children diagnosed with sickle cell anemia (SCA).
  • To identify risk factors associated with the development of OSAS in this pediatric cohort.
  • To inform clinical practice regarding screening and management of OSAS in children with SCA.

Main Methods:

  • Analysis of cross-sectional baseline data from the multicenter Sleep and Asthma Cohort Study.
  • Inclusion of children aged 4–18 years with SCA, unselected for sleep or asthma symptoms.
  • Utilized overnight polysomnography for OSAS diagnosis and multivariable logistic regression to identify risk factors.

Main Results:

  • OSAS was present in 41% (AHI ≥1) or 10% (AHI ≥5) of the 243 children with SCA.
  • Significant risk factors for OSAS included habitual snoring, lower waking pulse oxygen saturation (SpO2), reduced lung function, less caretaker education, and non-preterm birth.
  • Habitual snoring and lower waking SpO2 were the strongest predictors in multivariable analyses.

Conclusions:

  • The prevalence of OSAS in children with SCA is notably higher than in the general pediatric population.
  • Habitual snoring and low waking SpO2 are easily measurable and significant risk factors for OSAS in children with SCA.
  • Enhanced screening, diagnosis, and treatment of OSAS are crucial for this high-risk pediatric group due to its treatable nature and potential adverse outcomes.
Abstract

Keywords:
blood disorderscohort studyepidemiologyobstructive sleep apneapolysomnographysickle cell anemiasleep disorderssleep medicine

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