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The association between sleep disturbances and neurocognitive function in pediatric sickle cell disease

Tiffany Tucker1, Ammar Saadoon Alishlash2, Jeffrey D Lebensburger3

  • 1Department of Psychology, University of Alabama at Birmingham, Birmingham, AL, USA.

Sleep Medicine
|June 13, 2022
PubMed

Insights

Youth with sickle cell disease (SCD) experience neurocognitive difficulties linked to sleep disturbances. Lower nocturnal oxygen saturation negatively impacts verbal comprehension and working memory in these children.

Area of Science:

  • Pediatric Neurology
  • Sleep Medicine
  • Hematology

Background:

  • Youth with sickle cell disease (SCD) face a heightened risk of neurocognitive deficits, even without diagnosed neurological complications.
  • Nocturnal hypoxemia is a recognized chronic complication in pediatric SCD patients and is associated with impaired neurocognitive outcomes.
  • Understanding the link between sleep disturbances and cognitive function is crucial for managing SCD in youth.

Purpose of the Study:

  • To investigate the relationship between sleep disturbances and neurocognitive functioning in children and adolescents with SCD.
  • To examine the impact of nocturnal hypoxemia, specifically mean nocturnal oxygen saturation (SpO2) and time spent with SpO2 < 90%, on cognitive performance.
  • To consider demographic and socioeconomic factors in the analysis of sleep and neurocognition in pediatric SCD.

Main Methods:

  • Retrospective chart review identified 27 youth (ages 6-17) with SCD who completed standardized polysomnography (PSG).
  • Neuropsychological testing battery assessed cognitive skills including verbal comprehension, working memory, processing speed, and cognitive flexibility.
  • Parent-reported questionnaires evaluated executive and adaptive skills, complementing objective cognitive measures.

Main Results:

  • A decrease in mean nocturnal SpO2 was significantly associated with reduced verbal comprehension (p=0.031).
  • Increased time spent with SpO2 < 90% during sleep correlated with decreased working memory performance (p=0.030).
  • Other cognitive domains and parent-reported executive/behavioral ratings were not significantly predicted by the studied sleep parameters.

Conclusions:

  • Sleep disturbances, including nocturnal hypoxemia (mean SpO2 and time spent < 90%), significantly impact verbal comprehension and working memory in youth with SCD.
  • These findings highlight sleep as a modifiable factor that may contribute to neurocognitive deficits in pediatric SCD.
  • Sleep-targeted interventions could potentially mitigate neurocognitive challenges in youth with sickle cell disease.
Abstract

Keywords:
NeuropsychologyNocturnalPolysomnographySickle cell diseaseSocioeconomic statusYouth

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