Low daytime pulse oximetry reading is associated with nocturnal desaturation and obstructive sleep apnea in children with sickle cell anemia

Spivey, John F.; Uong, Elizabeth C.; Strunk, Robert C.; Boslaugh, Sarah; DeBaun, Michael R.

doi:10.1002/pbc.21054

Cited by 37 publications

(30 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…However, the more specifi c fi nding is of OSAS in 19% (seven of 36), which supports other studies evaluating the increased incidence of SDB and OSAS in this population. [4][5][6][7][8][9][10] Three important weaknesses related to our study should be mentioned. First, control subjects were excluded if any had a history of OSAS and/or previously underwent adenotonsillectomy.…”

Section: Discussionmentioning

confidence: 99%

“…We believe the current analysis can explain the high occurrence of OSAS in the subjects with SCD in our study and complements previous studies demonstrating a much higher prevalence of OSAS in subjects with SCD compared with the general population. [4][5][6][7][8][9][10] A few methodologic issues deserve comment. First, MRI is considered a reliable and accurate tool to evaluate the upper airway and surrounding soft tissues.…”

Section: Upper Airway Volumetric Measurementsmentioning

confidence: 99%

See 1 more Smart Citation

Upper Airway Lymphoid Tissue Size in Children With Sickle Cell Disease

Strauss

Sin

Marcus

et al. 2012

Chest

View full text Add to dashboard Cite

Sleep-disordered breathing (SDB), a condition associated with abnormalities in respiratory gas exchange during sleep (particularly intermittent oxyhemoglobin desaturation), has been implicated as a possible risk factor for deleterious cerebrovascular complications in children with sickle cell disease (SCD). [1][2][3] Although the prevalence of SDB in these children has not been well established, estimates range from 5% to 79% 4-10 and are far greater than the prevalence of 1% to 4% in children without SCD. 11 In addition, the pathophysiology of SDB in these children is not well understood. Possible mechanisms include hypoven tilation due to chronic lung disease, 12,13 obstructive sleep apnea syndrome (OSAS) 6 (a disorder characterized by recurrent events of partial or complete Background: The prevalence of obstructive sleep apnea syndrome (OSAS) is higher in children with sickle cell disease (SCD) as compared with the general pediatric population. It has been speculated that overgrowth of the adenoid and tonsils is an important contributor. Methods: The current study used MRI to evaluate such an association. We studied 36 subjects with SCD (aged 6.9 Ϯ 4.3 years) and 36 control subjects (aged 6.6 Ϯ 3.4 years). Results: Compared with control subjects, children with SCD had a signifi cantly smaller upper airway (2.8 Ϯ 1.2 cm 3 vs 3.7 Ϯ 1.6 cm 3 , P , .01), and signifi cantly larger adenoid (8.4 Ϯ 4.1 cm 3 vs 6.0 Ϯ 2.2 cm 3 , P , .01), tonsils (7.0 Ϯ 4.3 cm 3 vs 5.1 Ϯ 1.9 cm 3 , P , .01), retropharyngeal nodes

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Upper Airway Volumetric Measurementsmentioning

confidence: 99%

Upper Airway Lymphoid Tissue Size in Children With Sickle Cell Disease

Strauss

Sin

Marcus

et al. 2012

Chest

View full text Add to dashboard Cite

show abstract

“…This result differs from that of the study conducted by Kaleyias et al, (3) who applied a questionnaire to 100 children, selected only the 19 most severe cases of suspected SDB to undergo polysomnography and concluded that 53% of the selected children had OSAS. In another study, (1) only 35% of the 20 patients studied were found to have OSAS. However, the study population was not exclusively composed of patients with SCA, since patients with thalassemia were also included.…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, the exact prevalence, etiology and natural history of OSAS in patients with SCA has yet to be defined. (1) It is known that OSAS is associated with hypoxemia, hypercapnia and acidosis, which might induce the polymerization of hemoglobin S (Hb S), the potentiation of the sickling process and the onset of vaso-occlusive crises. (2) In addition, approximately 80% of children with SCA present nocturnal desaturation, which might be the result of OSAS.…”

Section: Introductionmentioning

confidence: 99%

Prevalência da apneia obstrutiva do sono em crianças e adolescentes portadores da anemia falciforme

Salles¹,

Ramos

Daltro

et al. 2009

J. bras. pneumol.

View full text Add to dashboard Cite

Objective: To estimate the prevalence of obstructive sleep apnea syndrome (OSAS) in children and adolescents with sickle cell anemia (SCA); to investigate the possible correlation between mean annual hemoglobin level and total sleep time with SpO 2 < 90%, as well as between mean annual hemoglobin level and total sleep time with SpO 2 < 80%; and to investigate the possible correlation between apnea-hypopnea index (AHI) and painful crisis. Methods: The study involved 85 patients with SCA. The patients completed a questionnaire, were submitted to polysomnography and underwent clinical evaluation (by a pediatrician and an otolaryngologist). An AHI > 1 was considered indicative of a diagnosis of OSAS. Results: The prevalence of OSAS was 10.6%. We found a negative correlation between mean annual hemoglobin level and total sleep time with SpO 2 < 90% (r = −0.343; p = 0.002), as well as between mean annual hemoglobin level and total sleep time with SpO 2 < 80% (r = −0.270; p = 0.016). There was no association between AHI and painful crisis. Conclusions: The prevalence of OSAS in this population was high (10.6%). Therefore, it is important to identify signs of OSAS as soon as possible and to determine the mean annual hemoglobin level because of the inverse correlation between that level and the total sleep time with SpO 2 < 90% or < 80%.Keywords: Prevalence; Sleep apnea, obstructive; Anemia, sickle cell; Polysomnography; Sleep apnea syndromes. ResumoObjetivo: Estimar a prevalência da síndrome da apneia obstrutiva do sono (SAOS) em crianças e adolescentes com anemia falciforme (AF) e investigar a possível correlação entre hemoglobina anual média e tempo total de sono com SpO 2 < 90% e tempo total de sono com SpO 2 < 80%, assim como investigar a possível correlação entre o índice de apneia-hipopneia (IAH) e episódios de crise álgica. Métodos: Participaram 85 pacientes com AF, que responderam a um questionário, foram avaliados por um pediatra e um otorrinolaringologista, e submetidos a estudo polissonográfico. O diagnóstico de SAOS foi definido como IAH > 1. Resultados: A prevalência da SAOS foi 10,6%. Observou-se uma correlação negativa entre hemoglobina anual média e tempo total de sono com SpO 2 < 90% (r = −0,343; p = 0,002) e tempo total de sono com SpO 2 < 80% (r = −0,270; p = 0,016). Não foi observada associação entre IAH e episódios de crise álgica. Conclusões: A prevalência da SAOS nesta população foi alta (10,6%). Portanto, é importante identificar precocemente os sinais de SAOS e avaliar hemoglobina anual média, devido à correlação inversa entre essa e o tempo total de sono com SpO 2 < 90% ou < 80%.

show abstract

“…Except for 1 study, 17,18 prevalence estimates have been based on samples clinically referred for OSAS symptoms [19][20][21][22][23] or with desaturation. 24,25 Furthermore, clinicians are uncertain whether the same symptoms, signs, and risk factors associated with OSAS in otherwise healthy children have clinical utility in screening for OSAS in children with SCA. 1 We used data from participants in the prospective Sleep and Asthma Cohort Study who were unselected for OSAS symptoms to investigate the prevalence and risk factors for OSAS in children with SCA.…”

mentioning

confidence: 99%

Obstructive Sleep Apnea and Sickle Cell Anemia

2014

PEDIATRICS

View full text Add to dashboard Cite

WHAT'S KNOWN ON THIS SUBJECT: Obstructive sleep apnea syndrome (OSAS) prevalence in children with sickle cell anemia is not well described. Although these children often experience nocturnal oxygen desaturation, it is unclear whether they are more likely to have OSAS.WHAT THIS STUDY ADDS: Children with sickle cell anemia have a high prevalence of OSAS with typical symptoms, beyond just nocturnal oxyhemoglobin desaturation. This study supports the need for increased efforts to screen for, diagnose, and treat OSAS in this vulnerable population. 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 SCArelated 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 inlaboratory 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 b 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 (SpO 2 ), reduced lung function, less caretaker education, and non-preterm birth. Lower sleep-related SpO 2 metrics were also associated with higher obstructive apnea hypopnea indices. In multivariable analyses, habitual snoring and lower waking SpO 2 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 SpO 2 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.

show abstract

Low daytime pulse oximetry reading is associated with nocturnal desaturation and obstructive sleep apnea in children with sickle cell anemia

Abstract: A retrospective medical record review was established to test the hypothesis that in children with sickle cell anemia (SCA), a daytime oxygen saturation (SpO(2)) Show more

Cited by 37 publications

References 19 publications

Upper Airway Lymphoid Tissue Size in Children With Sickle Cell Disease

Upper Airway Lymphoid Tissue Size in Children With Sickle Cell Disease

Prevalência da apneia obstrutiva do sono em crianças e adolescentes portadores da anemia falciforme

Obstructive Sleep Apnea and Sickle Cell Anemia

Contact Info

Product

Resources

About