Longitudinal Analysis of Sleep-Disordered Breathing and Cognitive Outcomes in Children Living With Sickle Cell
Shifa Hamdule1, Melanie Koelbel1,2, Johanna C Gavlak1,3
1Developmental Neurosciences Unit and NIHR Biomedical Research Centre, UCL Great Ormond Street Institute of Child Health, London, UK.
Insights
Sleep-disordered breathing (SDB) and cognitive function in children with sickle cell anaemia (SCA) were studied. Lower overnight oxygen saturation and central apnoea (CAI) impact cognitive outcomes in children with SCA.
Area of Science:
- Pediatric Hematology
- Sleep Medicine
- Neuropsychology
Background:
- Sleep-disordered breathing (SDB) and cognitive impairments are prevalent in children with sickle cell anaemia (SCA).
- Longitudinal data on sleep patterns and cognitive function in this population are limited.
Purpose of the Study:
- To investigate the longitudinal changes in polysomnographic (PSG) indices in children with SCA.
- To examine the association between PSG indices and cognitive outcomes in children with SCA.
Main Methods:
- Utilized data from the Sleep Asthma Cohort (SAC 1-3) with children aged 4-18 years with SCA.
- Assessed PSG indices including obstructive apnoea hypopnoea index (OAHI), central apnoea index (CAI), oxygen saturation, and total sleep time over two visits.
- Correlated PSG indices with cognitive assessments at Visit 3.
Main Results:
- Total sleep time decreased significantly between visits, while overall PSG indices remained stable.
- Mean overnight oxygen saturation at Visit 1 predicted working memory at Visit 3.
- Central apnoea index (CAI) at Visit 2 was linked to lower verbal comprehension and executive function scores.
Conclusions:
- PSG indices showed stability over time, but screening is advised due to sickle cell pathology complexity.
- Overnight oxygen saturation and central apnoea significantly influence cognitive outcomes in children with SCA.
Objectives:
Sleep-disordered breathing (SDB) and cognitive challenges are commonly observed in children living with sickle cell anaemia (SCA). This study investigated the longitudinal change in polysomnographic outcomes and the association with cognitive functions in children living with SCA.
Method:
Data from the Sleep Asthma Cohort (SAC 1, 2 and 3) included participants living with SCA (aged 4-18 years) who were initially recruited between 2006 and 2009, with follow-up studies conducted through until 2019. Polysomnographic indices (PSG indices), that is, obstructive apnoea hypopnoea index (OAHI), central apnoea index (CAI), mean overnight oxygen saturation and total sleep time, were assessed over two visits. Additional analyses assessed the impact of PSG indices on cognitive outcomes collected at Visit 3.
Results:
Ninety-two participants (91 HbSS, 1HbSβ) completed a PSG at Visit 1 and 56 participants returned for Visit 2, 40 of whom returned for the Visit 3 cognitive assessment; mean ages were 9.9 (3.8), 14.7 (3.69) and 17.7 (4.64) years, respectively. Total sleep time significantly decreased between the two visits, while overall PSG indices remained stable. Mean overnight oxygen saturation at Visit 1 significantly predicted working memory at Visit 3. In addition, CAI at Visit 2 was associated with lower scores on the verbal comprehension index and self or caregiver-reported measures of executive function.
Conclusions:
PSG indices did not change significantly over time; however, at least one PSG screening is recommended, given the complexity of sickle pathology. Overnight oxygen saturation levels and central apnoea influence cognitive outcomes for children living with SCA.
Related Concept Videos
Longitudinal Studies
Substance Use Disorders Affecting Sleep
Understanding the concepts of physical dependence,...
Chronic Obstructive Pulmonary Disease-IV: Assessement and Diagnostic Studies
Medical History
Sleep Apnea
The condition is more prevalent among...
Longitudinal Research


