Kids with Sickle Cell Disease and Sleep Apnea at Higher Risk of Complications, Study Finds

Children with sickle cell disease who experience obstructive sleep apnea (OSA), a breathing disorder during sleep, are at risk of developing additional health problems, according to researchers.

Their study, “Comorbid obstructive sleep apnea and increased risk for sickle cell disease morbidity,” was published in Sleep and Breathing.

It’s common for young sickle cell disease (SCD) patients to have sleeping disorders, including obstructive sleep apnea.

OSA is characterized by altered breathing during sleep, leading to intermittent low oxygenation levels and fragmented sleep. In the long term, the disorder can lead to daytime sleepiness, behavioral changes, cognitive deficits, growth delays, and heart disease.

To better understand the relationship between sickle cell disease and obstructive sleep apnea, a team from the University of South Carolina reviewed the medical records of 641 young sickle cell patients from a single hematology clinic.

The patients had been diagnosed with sickle cell anemia (58.2%), sickle hemoglobin C disease (25.7%), sickle cell-beta plus thalassemia (12.2%), sickle cell-beta zero thalassemia (2.2%), and other related genetic diseases (1.1%). Among the sickle cell disease patients, 136 had been diagnosed with secondary OSA during an 11-year follow-up period.

The team compared the health data of the 136 OSA patients with that of 136 age-matched SCD patients without obstructive sleep apnea. About 64.4% of patients were diagnosed with the sleep disorder before age 10, but diagnoses in the 20s were not unusual (35.6%).

Researchers found that children with OSA had 47% more health complications than those without obstructive sleep apnea. Additional analysis revealed that SCD children with the sleep disorder had higher rates of complications per year than healthy children (controls), even before OSA diagnosis.

The complications were primarily lung, neurologic, and cardiovascular problems, and infections. These were found to be associated with low oxygen levels during sleep.

These findings indicate that obstructive sleep apnea is an important contributor to health complications in SCD children. This means early diagnosis and treatment of the sleep disorder “should be a high priority for primary care physicians and specialists involved in SCD health care,” the researchers wrote.

“Routine screenings, diagnosis, and increased therapeutic intervention for children with comorbid OSA could decrease SCD morbidity,” they wrote.

Additional studies are needed to understand to what extent early interventions to prevent OSA could benefit these patients, the team added.