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Developmental Profile of Sleep and Its Potential Impact on Daytime Functioning from Childhood to Adulthood in Sickle
Melanie Kölbel1, Fenella J Kirkham1,2,3,4, Dagmara Dimitriou5
1Department of Developmental Neurosciences Unit, UCL Great Ormond Street Institute of Child Health, London WC1N 1EH, UK.
Insights
Sleep disturbances are common in children with sickle cell anaemia (SCA), affecting daytime functioning. Longitudinal data reveal changes in sleep patterns and increased daytime sleepiness, highlighting the need for comprehensive sleep assessments in SCA management.
Area of Science:
- Hematology
- Sleep Medicine
- Pediatrics
Background:
- Sickle cell anaemia (SCA) is associated with sleep disturbances and daytime tiredness in young individuals.
- These sleep issues can negatively impact daily functioning and academic performance.
- Longitudinal data on sleep in SCA patients are limited.
Purpose of the Study:
- To assess the developmental sleep profiles of children and young adults aged 4-23 with SCA.
- To examine longitudinal changes in sleep patterns and their relationship with daytime functioning.
- To identify factors influencing sleep quantity and quality in this population.
Main Methods:
- Retrospective analysis of polysomnography (PSG) and questionnaire data from 256 children with SCA.
- In-hospital PSG and sleep habit/behavior data collected concurrently.
- Follow-up PSG data collected 1.80-6.72 years later on 179 participants.
Main Results:
- Later bedtimes and decreased total sleep time (TST) were observed over time.
- Sleep disturbances like parasomnias and night waking were most prevalent in preschool children and young adults.
- Lower sleep quality, increased nocturnal movements, and night waking correlated with daytime sleepiness.
Conclusions:
- Sleep plays a crucial role in daytime functioning for individuals with SCA.
- Quantitative (PSG) and qualitative (questionnaire) sleep assessments are essential for guiding interventions.
- Comprehensive sleep evaluations are recommended for managing SCA patients.
Abstract:
Young individuals with sickle cell anaemia (SCA) experience sleep disturbances and often experience daytime tiredness, which in turn may impact on their daytime functioning and academic attainment, but there are few longitudinal data.
Methods:
Data on sleep habits and behaviour were taken on the same day as an in-hospital polysomnography. This study assesses the developmental sleep profiles of children and young adults aged 4-23 years old with SCA. We examined retrospective polysomnography (PSG) and questionnaire data.
Results:
A total of 256 children with a median age of 10.67 years (130 male) were recruited and 179 returned for PSG 1.80-6.72 years later. Later bedtimes and a decrease in total sleep time (TST) were observed. Sleep disturbances, e.g., parasomnias and night waking, were highest in preschool children and young adults at their first visit. Participants with lower sleep quality, more movement during the night and increased night waking experienced daytime sleepiness, potentially an indicator of lower daytime functioning. Factors influencing sleep quantity included age, hydroxyurea prescription, mean overnight oxygen saturation, sleep onset latency, periodic limb movement, socioeconomic status and night waking.
Conclusion:
Sleep serves an important role for daytime functioning in SCA; hence, quantitative (i.e., PSG for clinical symptoms, e.g., sleep-disordered breathing, nocturnal limb movement) and qualitative (i.e., questionnaires for habitual sleep behaviour) assessments of sleep should be mutually considered to guide interventions.
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