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Does Obstructive Sleep Apnea Increase Cognitive Deficits in Pediatric Sickle Cell Disease?
Sarah E Bills1, Tal Katz1, Jaleel McNeil1
1Department of Psychology, University of South Carolina, Columbia, South Carolina 29208, USA.
Insights
Children with sickle cell disease (SCD) and obstructive sleep apnea (OSA) show similar cognitive deficits as those with SCD alone. However, severe OSA may worsen neurocognitive impairments in children with SCD.
Area of Science:
- Pediatric hematology
- Sleep medicine
- Neuropsychology
Background:
- Pediatric obstructive sleep apnea (OSA) affects 2-3% of children, but over 40% of those with sickle cell disease (SCD).
- Neurocognitive deficits are seen in both pediatric OSA and SCD, yet their interaction is understudied.
- Understanding this interaction is crucial for managing SCD complications.
Purpose of the Study:
- To investigate the impact of obstructive sleep apnea (OSA) on neurocognitive deficits in children with sickle cell disease (SCD).
- To determine if comorbid OSA exacerbates cognitive impairments in children with SCD.
Main Methods:
- Cognitive function was assessed in three groups: children with SCD and OSA (n=26), children with SCD only (n=39), and healthy children (n=59).
- Standardized tests measured processing speed, reading decoding, quantitative knowledge, and visual-spatial construction.
Main Results:
- Children with chronic health conditions (SCD with or without OSA) scored lower on processing speed and reading decoding than healthy children.
- The SCD-only group performed worse on quantitative knowledge and visual-spatial tests compared to healthy controls.
- No additive cognitive impact of OSA was found; however, more severe OSA correlated with lower processing speed and quantitative knowledge in the SCD+OSA group.
Conclusions:
- Comorbid OSA does not worsen cognitive deficits in children with SCD compared to SCD alone.
- Severe obstructive sleep apnea (OSA) may represent an additional risk factor for neurocognitive impairments in children with sickle cell disease (SCD).
Objectives:
Although pediatric obstructive sleep apnea (OSA) is estimated to affect 2-3% of the general population, its prevalence in sickle cell disease (SCD) is much higher, with research suggesting a prevalence rate of upwards of 40%. Despite the similar underlying pathophysiological mechanisms of neurocognitive effects in pediatric OSA and SCD, there is a scarcity of information on how these two conditions interact. The aim of this study was to better understand the contribution of sleep apnea to neurocognitive deficits in children diagnosed with SCD.
Method:
This study assessed cognitive function in 26 children with comorbid SCD and OSA, 39 matched comparisons with SCD only, and 59 matched comparisons in children without a chronic health condition.
Results:
There were significant differences on measures of processing speed and reading decoding, with children without a chronic health condition scoring better than both chronic health condition groups. Additionally, the no chronic health condition group performed better on a test of quantitative knowledge and reasoning and a test of visual-spatial construction than the SCD-only group. Contrary to our hypotheses, there were no between-group differences suggesting an additive impact of OSA on cognition. Exploratory analyses revealed associations within the group that had OSA showing that more severe OSA correlated with lower performance on measures of processing speed and quantitative knowledge/reasoning.
Conclusions:
Children with comorbid OSA and SCD do not present with greater deficits in cognitive functioning than children with SCD alone. However, severe OSA may confer additional risk for neurocognitive impairments.
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