The association between sleep disturbances and neurocognitive function in pediatric sickle cell disease

Tucker, Tiffany; Alishlash, Ammar Saadoon; Lebensburger, Jeffrey D.; Clay, Olivio J.; Oates, Gabriela R.; Nourani, Anis; Bhatia, Smita; Murdaugh, Donna L.

doi:10.1016/j.sleep.2022.05.015

Cited by 7 publications

(4 citation statements)

References 80 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…15 This study is limited by its small size and lack of longitudinal oximetry testing or assessments of possible aetiologies. In children, the reported clinical associations with nocturnal hypoxaemia are cerebrovascular, cardiopulmonary and genitourinary [3][4][5][6][7][8][9] and we were unable to thoroughly examine these in this study; larger cohorts with more extensive longitudinal follow-up may better elucidate these associations in adults. Given plausible pathophysiological sequelae to hypoxia in SCD, we are planning a larger prospective study to investigate the true prevalence of nocturnal hypoxaemia, associations with neurocognitive impairment, the role of cardiopulmonary abnormalities and implicated biomarkers.…”

Section: Baseline Valuesmentioning

confidence: 88%

“…1 In the general population, hypoxia is implicated in reactive oxygen species (ROS) formation and accelerated cardiovascular disease. 2 Hypoxia is relatively common in children with sickle cell anaemia (SCA) 3,4 and impacts brain, 5,6 genitourinary 7,8 and heart health; 9 however, the prevalence and clinical impact of hypoxia in adults with SCA is not well described. Therefore, we examined adults with SCA who were seen at a single institution for nocturnal hypoxaemia with the goal of estimating prevalence, examining comorbid clinical complications and identifying relevant cellular and plasma biomarkers.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Nocturnal hypoxaemia is common in adults with sickle cell anaemia

Chang,

Wilson,

Morris

et al. 2024

Br J Haematol

View full text Add to dashboard Cite

SummaryThe symptoms and sequelae of sickle cell anaemia (SCA) are caused by the polymerization of deoxygenated sickle haemoglobin, and people with SCA may be uniquely susceptible to adverse outcomes from hypoxia and haemoglobin desaturation. We examined by oximetry adults (aged 18–45 years) with SCA presenting symptoms indicative of polysomnography, at a single institution, irrespective of treatment, for nocturnal hypoxaemia. Clinical labs and blood for in vitro assessments were taken upon enrolment and after 8–12 weeks of oxygen therapy or observation. Of 21 screened participants, nine (43%) had sufficient nocturnal hypoxaemia to warrant oxygen therapy (≥5 min at SpO2 ≤ 88%). Time spent at SpO2 ≤ 88% associated with age (p = 0.0092), annual hospitalizations (p = 0.0018) and anaemia (p = 0.0139), as well as plasma levels of TNFα (p = 0.0019) and IL‐4 (p = 0.0147). Longitudinal analysis showed that WBC significantly decreased during the follow‐up period in hypoxic individuals but not in non‐hypoxic individuals (p = 0.0361 and p = 0.6969 respectively). Plasma levels of CCL2 and IL‐1ra tended to increase, while levels of red blood cell reactive oxygen species tended to decrease with oxygen therapy. Overall, nocturnal hypoxaemia was common in this pilot study population and associated with plausible clinical comorbidities; oxygen therapy may decrease inflammation and oxidative damage in hypoxic individuals.

show abstract

Section: Baseline Valuesmentioning

confidence: 88%

mentioning

confidence: 99%

Nocturnal hypoxaemia is common in adults with sickle cell anaemia

Chang,

Wilson,

Morris

et al. 2024

Br J Haematol

View full text Add to dashboard Cite

show abstract

“…7 Research from 2022 investigated sleep disruptions and neurocognitive performance in pediatric SCD. 8 This study's results could broaden expanded the discussion given the interrelatedness of pain, sleep, and neurocognitive performance. Gil et al 9 examined SCD children and adolescents pain frequency and coping techniques throughout time.…”

Section: E T T E R T O T H E E D I T O R Comment On: Intraindividual ...mentioning

confidence: 89%

Comment on: Intraindividual pain variability metrics for youth with sickle cell disease: Relations to health outcomes

Mushtaq

Kumar

Khatri

2023

Pediatric Blood & Cancer

View full text Add to dashboard Cite

“…Given that children living with SCA experience processing speed and executive function (cognitive flexibility) difficulties [45], understanding of how these cognitive domains interact along with the roles of infarction and reduced oxygen delivery in SCA (i.e., oxygen saturation, hemoglobin) is urgently needed. Despite advances in care and increased availability of disease-modifying treatments [46][47][48], previous research has demonstrated that executive function problems in children living with SCD are related to sleep difficulties [49], reduced social skills [41], challenges with pain coping and quality of life [50][51][52], and persistent pain [53]. Critically, adolescents with SCD exhibit significant challenges with managing their medical care and decision-making [54,55], likely because these decisions require executive function (remembering information) and language comprehension (understanding and reasoning) skills.…”

Section: Introductionmentioning

confidence: 99%

Executive Function and Processing Speed in Children Living with Sickle Cell Anemia

Kelleher,

Kirkham,

Hood

2023

Children

View full text Add to dashboard Cite

Executive function and processing speed difficulties are observed in children living with sickle cell anemia (SCA). The influence of processing speed on executive function is not well understood. We recruited 59 children living with SCA and 24 matched controls aged 8–18 years between 2010 and 2016 from clinics in the UK. Children completed tests in processing speed and cognitive flexibility, subdomains of executive function. MRI scans were conducted within one year of testing; oxygen saturation was obtained on the day of testing. Hemoglobin levels were obtained from medical records. Caregivers completed the executive function questionnaire. Hierarchical linear regressions found that hemoglobin, oxygen saturation, age, infarct status, and processing speed were not independent predictors for any model. However, for all cognitive flexibility tests, there was a significant interaction between infarct status and processing speed; children without silent cerebral infarction (SCI) with faster processing speed had better cognitive flexibility. Our findings indicate that, when interpreting executive function difficulties, it is important to account for the relationship between SCI status and processing speed. More research is needed to elucidate the mechanisms, but clinically, including executive function testing as part of clinic visits by embedding psychologists within the healthcare team would appear to be a critical step.

show abstract

The association between sleep disturbances and neurocognitive function in pediatric sickle cell disease

Cited by 7 publications

References 80 publications

Nocturnal hypoxaemia is common in adults with sickle cell anaemia

Nocturnal hypoxaemia is common in adults with sickle cell anaemia

Comment on: Intraindividual pain variability metrics for youth with sickle cell disease: Relations to health outcomes

Executive Function and Processing Speed in Children Living with Sickle Cell Anemia

Contact Info

Product

Resources

About