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Updated: Aug 6, 2026

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Published on: December 6, 2016

The Natural History of Snoring in Children With Sickle Cell Anemia in Relation to Upper Airway Anatomy and OSA

Mariam Z Quraishi1, Diana Larrain2, Neethu M Menon2

  • 1CUNY School of Medicine, New York, NY, USA.

Pediatric Pulmonology
|July 23, 2026
PubMed

Insights

In children with sickle cell anemia, habitual snoring is a key indicator for obstructive sleep apnea. Its presence or absence reflects changes in upper airway anatomy, necessitating regular monitoring.

Area of Science:

  • Pediatric Pulmonology
  • Sleep Medicine
  • Genetics and Hematology

Background:

  • Children with sickle cell anemia (SCA) face a higher risk of sleep-disordered breathing (SDB).
  • The progression of obstructive sleep apnea (OSA) and optimal screening methods in this population require further investigation.
  • Understanding SDB symptoms and their link to OSA can simplify screening protocols.

Purpose of the Study:

  • To longitudinally characterize the SDB symptom profile in children with SCA.
  • To examine the evolution of SDB symptoms in relation to upper airway anatomy.
  • To identify reliable indicators for OSA screening in pediatric SCA patients.

Main Methods:

  • Prospective recruitment of patients with SCA aged 2-18 years.
  • Collection of demographic data, clinical assessments, and upper airway examinations.
  • Comparison of OSA symptoms with polysomnography (PSG) outcomes and anatomical features.

Main Results:

  • Habitual snoring was the most frequent SDB symptom (36%).
  • Among participants evaluated by PSG (60%), 58.7% had overlapping symptoms, with 78% including habitual snoring.
  • Habitual snoring, unlike other SDB symptoms, was significantly associated with OSA (p=0.017). Tonsillar hypertrophy and higher Mallampati scores predicted habitual snoring.
  • New-onset snoring correlated with larger tonsils, while snoring resolution was linked to lower Mallampati scores, indicating dynamic anatomical changes.

Conclusions:

  • Habitual snoring serves as a practical clinical indicator for preliminary OSA assessment in children with SCA.
  • The emergence and resolution of habitual snoring are linked to dynamic changes in upper airway anatomy.
  • Periodic reassessments are crucial due to the evolving nature of SDB symptoms and upper airway anatomy in pediatric SCA patients.
Abstract

Keywords:
screeningsickle cell diseasesleep apneasleep disorder breathingsnoring

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