Stroke associated with obstructive sleep apnea in a child with sickle cell anemia

We describe a child with sickle cell anemia and multiple ischemic infarctions who was found to have severe obstructive sleep apnea and hypoxemia, secondary to adenotonsillar enlargement. The apnea-associated hypoxemia likely contributed to the development of the strokes in this child. Moreover, because stroke in patients with sickle cell anemia, and maximal tonsillar enlargement (the most common cause of obstructive apnea in children) both have peak incidence at the same age (6-7 years), obstructive sleep apnea may be an important factor in the development of stroke in other children with sickle cell anemia.