Sickle cell anemia raises risk for obstructive sleep apnea syndrome

Children with sickle cell anemia (SCA) are more likely to have obstructive sleep apnea syndrome (OSAS) than the general pediatric population, with habitual snoring and low waking pulse oxygen saturation the strongest risk factors for developing the condition. Other risk factors for OSAS in these children revealed by a recent study were reduced lung function, less caretaker education, and non–preterm birth.

These were the major findings from the Sleep and Asthma Cohort Study, which evaluates the contribution of sleep and breathing abnormalities to SCA-related morbidity in youngsters aged 4 to 18 years. Investigators determined OSAS status from overnight polysomnography and the presence of generally accepted risk factors, as indicated on parental questionnaires and from direct measurements.

The 243 study participants (median age, 10 years) were recruited from pediatric centers in 3 cities, and the vast majority were of African heritage and homozygous for sickle cell hemoglobin. Obstructive sleep apnea syndrome was present in 41% or 10% of participants, depending on which obstructive apnea hypopnea index (OAHI) cutoff points were used. Frequency of habitual snoring, trouble breathing, witnessed apnea, and nocturnal enuresis increased with OAHI values; nocturnal restlessness or daytime sleepiness did not (Rosen CL, et al. Pediatrics. 2014;134[2]:273-281).

Ms Freedman is a freelance medical editor and writer in New Jersey. Dr Burke, section editor for Journal Club, is chairman of the Department of Pediatrics at Saint Agnes Hospital, Baltimore, Maryland. The editors have nothing to disclose in regard to affiliations with or financial interests in any organizations that may have an interest in any part of this article.