Sleep Apnea Screening in Children with Sickle Cell Anemia.

Abstract

Background: Children with Sickle-Cell Anemia (SCA) are at high risk for obstructive sleep apnea (OSA). Screening for OSA is therefore recommended by current guidelines but no specific method described. The Pediatric Sleep Questionnaire (PSQ) is a validated detection tool for OSA in children. We assessed the utility of PSQ to screen for OSA in snoring children with SCA. Methods: A prospective study in children with SCA, aged 4 - 18 years. Subjects were assessed for snoring and PSQ administered at the same visit. All snoring children were then referred for polysomnography (PSG). Results: A total of 106 subjects were screened. Mean age was 10.5 years and 47.2% male. Snoring prevalence was 51/106 (48.1%). In the snoring group, OSA was detected in 83.9% (AHI ≥ 1.0/h) and 22.6% (AHI ≥ 5.0/h), respectively. Sensitivity and specificity of PSQ in snoring children was 46.2% and 20.0% (AHI ≥ 1.0/h), and 57.1% and 50.0% (AHI ≥ 5.0/h), respectively. Physician assessment of snoring had a high sensitivity of 70.3% but low specificity of 58.4% (AHI ≥1.0/h), and 87.5% and 41.5% (AHI ≥ 5.0/h), respectively. Conclusion: PSQ is a poor screening tool for detection of OSA in snoring children with SCA. Physician assessment of snoring however could be an initial approach prior to polysomnography.