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The Impact of Sleep on Neurologic and Neurocognitive Complications in Children With Sickle Cell Disease: A Scoping

Rachel R Rice1, Ambika G Chidambaram2, Kiran Nandalike2

  • 1Department of Pediatrics, Pediatric Residency Program, University of California, Davis, California, USA.

Pediatric Blood & Cancer
|May 26, 2025
PubMed

Insights

Sleep-disordered breathing in children with sickle cell disease worsens neurologic and cognitive issues. Early screening and treatment of sleep disorders are vital for better outcomes in these children.

Area of Science:

  • Pediatric Neurology
  • Sleep Medicine
  • Hematology

Background:

  • Sleep-disordered breathing (SDB) is common in children with sickle cell disease (SCD).
  • SDB involves sleep fragmentation and hypoxia, impacting neurologic health.
  • The link between SDB and neurologic/neurocognitive outcomes in pediatric SCD is a growing concern.

Purpose of the Study:

  • To review and synthesize data on the impact of sleep disruption and SDB on neurologic and neurocognitive complications in children with SCD.
  • To enhance understanding of the relationship between SDB and adverse outcomes in pediatric SCD.
  • To inform clinical practice regarding sleep disorders in children with SCD.

Main Methods:

  • Comprehensive literature search of Medline, PubMed, and Cochrane databases (inception to March 2023).
  • Inclusion of studies assessing neurologic outcomes or cognitive function in pediatric SCD patients with SDB.
  • Screening of 542 studies, with 21 studies meeting inclusion criteria.

Main Results:

  • SDB is linked to increased stroke risk, higher transcranial Doppler velocities, and cerebral vasculopathy in children with SCD.
  • Nocturnal hypoxemia and fragmented sleep correlate with neurocognitive deficits (reduced IQ, verbal comprehension, executive function).
  • Interventions like adenotonsillectomy and CPAP improved sleep and mitigated neurocognitive deficits.

Conclusions:

  • SDB exacerbates the neurologic burden in pediatric SCD via hypoxia, oxidative stress, and inflammation.
  • Screening for sleep disorders in children with SCD is crucial.
  • Timely intervention for SDB can improve neurologic and cognitive outcomes in this population.

Keywords:
hypoxemianeurocognitiveneurologicsickle cell diseasesleep

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