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Published on: December 6, 2016
Comorbid obstructive sleep apnea and increased risk for sickle cell disease morbidity
Tal Katz1, Jeffrey Schatz2, Carla W Roberts3
1Department of Psychology, University of South Carolina, 1512 Pendleton Street, Columbia, SC, 29208, USA.
Insights
Children with sickle cell disease (SCD) and obstructive sleep apnea (OSA) face more complications. Early screening and treatment for OSA in pediatric SCD patients can reduce serious health issues.
Area of Science:
- Pediatric Hematology
- Sleep Medicine
- Pulmonology
Background:
- Sickle cell disease (SCD) increases the risk of obstructive sleep apnea (OSA) in children.
- Comorbid OSA in pediatric SCD is linked to increased pain and neurological issues.
Purpose of the Study:
- To determine the rate of various SCD-related medical complications in children with OSA.
- To better understand the spectrum of SCD complications associated with OSA.
Main Methods:
- Retrospective chart review of 641 youth with SCD over 11 years.
- Comparison of complication rates between 136 children with SCD and OSA and 136 matched controls at lower OSA risk.
Main Results:
- Children with SCD and OSA had higher overall SCD complication rates than controls.
- Lung morbidity, infections, cardiovascular, and neurological complications were more frequent in children with OSA.
- Elevated complication rates were observed both before and after OSA diagnosis.
Conclusions:
- OSA is associated with a wider range of SCD complications in children, including pneumonia and acute chest syndrome.
- Routine OSA screening, diagnosis, and treatment can potentially decrease SCD morbidity.
Purpose:
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.
Methods:
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.
Results:
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.
Conclusions:
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.
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