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Association of sleep study outcomes and health care utilization in children with sickle cell disease: a multicenter

Ammar S Alishlash1, Anis Rabbani Nourani1, Dima Ezmigna2

  • 1Department of Pediatrics, Heersink School of Medicine, The University of Alabama at Birmingham, Birmingham, AL.

Blood Advances
|July 3, 2025
PubMed

Insights

Nocturnal hypoxemia, measured by percent total sleep time with oxygen saturation below 90% (TST90), significantly increases healthcare use in children with sickle cell disease (SCD). Treating sleep issues may reduce emergency visits and hospitalizations.

Area of Science:

  • Pediatric Hematology
  • Sleep Medicine
  • Health Services Research

Background:

  • Sickle cell disease (SCD) is linked to higher healthcare utilization.
  • Sleep disorders are associated with increased SCD complications.
  • Understanding sleep's impact on SCD healthcare needs is crucial.

Purpose of the Study:

  • To investigate the association between polysomnography (PSG) findings and healthcare utilization in pediatric SCD patients.
  • To identify specific sleep study parameters that predict increased healthcare use.

Main Methods:

  • Multicenter retrospective cohort study of 210 children with SCD undergoing PSG.
  • Analysis of healthcare utilization (ED visits, hospital admissions) 2 years pre- and post-PSG.
  • Statistical analysis including univariate and multivariate regression.

Main Results:

  • Nocturnal hypoxemia (higher percent TST90) and periodic leg movement index correlated with increased healthcare utilization.
  • Obstructive sleep apnea and arousal index were not significantly associated.
  • Percent TST90 remained a significant predictor of healthcare utilization in multivariate analysis, more than doubling utilization.

Conclusions:

  • Nocturnal hypoxemia, indicated by percent TST90, is a significant risk factor for increased healthcare utilization in children with SCD.
  • Targetable interventions for sleep disorders may reduce healthcare burden in pediatric SCD.
  • Further research is needed to confirm findings and evaluate treatment efficacy.

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