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Pediatric Obstructive Sleep Apnea and Sickle Cell Disease: Demographic and Polysomnographic Features

Claire A Abijay1, W Craig Kemper1, An Pham1,2

  • 1Children's Medical Center Dallas, Dallas, Texas, USA.

The Laryngoscope
|March 8, 2023
PubMed

Insights

Children with sickle cell disease (SCD) are at risk for severe obstructive sleep apnea (OSA). While they have lower obesity rates and apnea-hypopnea index (AHI), they experience more nocturnal hypoxemia.

Area of Science:

  • Pediatric Pulmonology
  • Hematology
  • Sleep Medicine

Background:

  • Obstructive sleep apnea (OSA) is a common comorbidity in children with sickle cell disease (SCD).
  • Understanding the specific characteristics of OSA in this population is crucial for effective management.

Purpose of the Study:

  • To compare the demographic, clinical, and polysomnographic features of children with and without SCD undergoing polysomnography (PSG) for OSA.
  • To identify risk factors for severe OSA in children with SCD.

Main Methods:

  • Retrospective chart review of children aged 1-18 years referred for PSG.
  • Comparison of two groups: children with SCD (n=89) and without SCD (n=192).
  • Analysis of demographic data, clinical history, and polysomnographic parameters including apnea-hypopnea index (AHI) and oxygen saturation.

Main Results:

  • Children with SCD were predominantly African American (95% vs. 28%) with lower BMI z-scores and obesity rates (13% vs. 52%) compared to the non-SCD group.
  • The SCD group had a lower mean AHI (13.6 vs. 22.4) but a higher percentage of sleep time with oxygen saturation below 90% (10.5% vs. 3.5%).
  • Severe OSA was diagnosed in 43% of children with SCD, and the likelihood of severe OSA decreased with increasing age in this group.

Conclusions:

  • Children with SCD referred for PSG are at significant risk for severe OSA, characterized by nocturnal hypoxemia despite lower AHIs.
  • Demographic and clinical differences exist between children with and without SCD concerning OSA.
  • Age is a factor influencing the severity of OSA in children with SCD.
Abstract

Keywords:
childrenobstructive sleep apneapolysomnographysickle cell disease

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