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Obstructive sleep apnea and sickle cell anemia

Obstructive sleep apnea and sickle cell anemia
Obstructive sleep apnea and sickle cell anemia

OBJECTIVE: To ascertain the prevalence of and risk factors for obstructive sleep apnea syndrome (OSAS) in children with sickle cell anemia (SCA).

METHODS: Cross-sectional baseline data were analyzed from the Sleep and Asthma Cohort Study, a multicenter prospective study designed to evaluate the contribution of sleep and breathing abnormalities to SCA-related morbidity in children ages 4 to 18 years, unselected for OSAS symptoms or asthma. Multivariable logistic regression assessed the relationships between OSAS status on the basis of overnight in-laboratory polysomnography and putative risk factors obtained from questionnaires and direct measurements.

RESULTS: Participants included 243 children with a median age of 10 years; 50% were boys, 99% were of African heritage, and 95% were homozygous for β(S) hemoglobin. OSAS, defined by obstructive apnea hypopnea indices, was present in 100 (41%) or 25 (10%) children at cutpoints of ≥1 or ≥5, respectively. In univariate analyses, OSAS was associated with higher levels of habitual snoring, lower waking pulse oxygen saturation (Spo2), reduced lung function, less caretaker education, and non-preterm birth. Lower sleep-related Spo2 metrics were also associated with higher obstructive apnea hypopnea indices. In multivariable analyses, habitual snoring and lower waking Spo2 remained risk factors for OSAS in children with SCA.

CONCLUSIONS: The prevalence of OSAS in children with SCA is higher than in the general pediatric population. Habitual snoring and lower waking Spo2 values, data easily obtained in routine care, were the strongest OSAS risk factors. Because OSAS is a treatable condition with adverse health outcomes, greater efforts are needed to screen, diagnose, and treat OSAS in this high-risk, vulnerable population.

Adolescent, Anemia, Sickle Cell, Child, Child, Preschool, Comorbidity, Female, Humans, Male, Multivariate Analysis, Oximetry, Prevalence, Risk Factors, Sleep Apnea, Obstructive, Young Adult, Journal Article, Research Support, Non-U.S. Gov't
0031-4005
273-281
Rosen, Carol L.
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Debaun, Michael R.
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Strunk, Robert C.
014a33a8-1e21-4ee9-8b32-2cfb453f033d
Redline, Susan
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Seicean, Sinziana
1c403738-0fda-4934-8012-a45a1dfc0462
Craven, Daniel I.
724db4d4-4ad2-40f2-8dd2-cc66c2ae7854
Gavlak, Johanna C.D.
ce7eafab-5091-4a88-8f23-c94ebba658dc
Wilkey, Olu
adb1eb81-8a3f-4966-820e-2d4d2d78a476
Inusa, Baba
830cfc6c-2482-4986-b2d3-9edd5cf2d9f5
Roberts, Irene
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Goodpaster, R. Lucas
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Malow, Beth
30fd2afe-dbc1-4058-b033-f0892250df8a
Rodeghier, Mark
fa844b56-b6c4-4dd5-affd-f56b0b23e24e
Kirkham, Fenella J.
1dfbc0d5-aebe-4439-9fb2-dac6503bcd58
Rosen, Carol L.
3a8d9aa4-397d-47f6-8791-3df3e42eb1a5
Debaun, Michael R.
76559153-80c6-4642-bdf8-672a75570dfe
Strunk, Robert C.
014a33a8-1e21-4ee9-8b32-2cfb453f033d
Redline, Susan
3466f7f2-aa34-4c87-b8f1-37e039f6f0bd
Seicean, Sinziana
1c403738-0fda-4934-8012-a45a1dfc0462
Craven, Daniel I.
724db4d4-4ad2-40f2-8dd2-cc66c2ae7854
Gavlak, Johanna C.D.
ce7eafab-5091-4a88-8f23-c94ebba658dc
Wilkey, Olu
adb1eb81-8a3f-4966-820e-2d4d2d78a476
Inusa, Baba
830cfc6c-2482-4986-b2d3-9edd5cf2d9f5
Roberts, Irene
6e025a6a-755f-4340-9a45-a99b0fde116b
Goodpaster, R. Lucas
14162bcc-aa8a-400f-b085-8eb4193cd7b2
Malow, Beth
30fd2afe-dbc1-4058-b033-f0892250df8a
Rodeghier, Mark
fa844b56-b6c4-4dd5-affd-f56b0b23e24e
Kirkham, Fenella J.
1dfbc0d5-aebe-4439-9fb2-dac6503bcd58

Rosen, Carol L., Debaun, Michael R., Strunk, Robert C., Redline, Susan, Seicean, Sinziana, Craven, Daniel I., Gavlak, Johanna C.D., Wilkey, Olu, Inusa, Baba, Roberts, Irene, Goodpaster, R. Lucas, Malow, Beth, Rodeghier, Mark and Kirkham, Fenella J. (2014) Obstructive sleep apnea and sickle cell anemia. Pediatrics, 134 (2), 273-281. (doi:10.1542/peds.2013-4223).

Record type: Article

Abstract

OBJECTIVE: To ascertain the prevalence of and risk factors for obstructive sleep apnea syndrome (OSAS) in children with sickle cell anemia (SCA).

METHODS: Cross-sectional baseline data were analyzed from the Sleep and Asthma Cohort Study, a multicenter prospective study designed to evaluate the contribution of sleep and breathing abnormalities to SCA-related morbidity in children ages 4 to 18 years, unselected for OSAS symptoms or asthma. Multivariable logistic regression assessed the relationships between OSAS status on the basis of overnight in-laboratory polysomnography and putative risk factors obtained from questionnaires and direct measurements.

RESULTS: Participants included 243 children with a median age of 10 years; 50% were boys, 99% were of African heritage, and 95% were homozygous for β(S) hemoglobin. OSAS, defined by obstructive apnea hypopnea indices, was present in 100 (41%) or 25 (10%) children at cutpoints of ≥1 or ≥5, respectively. In univariate analyses, OSAS was associated with higher levels of habitual snoring, lower waking pulse oxygen saturation (Spo2), reduced lung function, less caretaker education, and non-preterm birth. Lower sleep-related Spo2 metrics were also associated with higher obstructive apnea hypopnea indices. In multivariable analyses, habitual snoring and lower waking Spo2 remained risk factors for OSAS in children with SCA.

CONCLUSIONS: The prevalence of OSAS in children with SCA is higher than in the general pediatric population. Habitual snoring and lower waking Spo2 values, data easily obtained in routine care, were the strongest OSAS risk factors. Because OSAS is a treatable condition with adverse health outcomes, greater efforts are needed to screen, diagnose, and treat OSAS in this high-risk, vulnerable population.

Full text not available from this repository.

More information

Published date: August 2014
Additional Information: Copyright © 2014 by the American Academy of Pediatrics.
Keywords: Adolescent, Anemia, Sickle Cell, Child, Child, Preschool, Comorbidity, Female, Humans, Male, Multivariate Analysis, Oximetry, Prevalence, Risk Factors, Sleep Apnea, Obstructive, Young Adult, Journal Article, Research Support, Non-U.S. Gov't

Identifiers

Local EPrints ID: 420596
URI: https://eprints.soton.ac.uk/id/eprint/420596
ISSN: 0031-4005
PURE UUID: 328351a5-27ba-4e03-9b9c-07b4cb3a5653
ORCID for Fenella J. Kirkham: ORCID iD orcid.org/0000-0002-2443-7958

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Date deposited: 10 May 2018 16:30
Last modified: 05 Nov 2019 01:53

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Contributors

Author: Carol L. Rosen
Author: Michael R. Debaun
Author: Robert C. Strunk
Author: Susan Redline
Author: Sinziana Seicean
Author: Daniel I. Craven
Author: Johanna C.D. Gavlak
Author: Olu Wilkey
Author: Baba Inusa
Author: Irene Roberts
Author: R. Lucas Goodpaster
Author: Beth Malow
Author: Mark Rodeghier
Author: Fenella J. Kirkham ORCID iD

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