Pediatric Obstructive Sleep Apnea and Sickle Cell Disease: Demographic and Polysomnographic Features

Objective: Obstructive sleep apnea (OSA) is prevalent in children with sickle cell disease (SCD). We compared the demographic, clinical, and polysomnographic characteristics of children with and without SCD. Methods: This retrospective chart review included children with SCD (n = 89) and without SCD (n = 192) ages 1–18 years referred for polysomnography (PSG) for OSA. Results: Children with SCD were predominantly African American when compared to the non-SCD group (95% vs. 28%, p < 0.001). The non-SCD group had a higher BMI z-score (1.3 vs. 0.1, p < 0.001) and a higher percentage of patients classified as obese (52% vs. 13%, p < 0.001). In children with SCD, 43% had severe OSA and 5.6% had no OSA. In the non-SCD group, 67% had severe OSA and 4.7% had no OSA. The SCD compared to the non-SCD group had a lower mean apnea-hypopnea index (AHI) (13.6 vs. 22.4, p = 0.006) but a higher percent sleep time below 90% oxygen saturation (10.5% vs. 3.5%, p < 0.001). Predicted probability for severe OSA in children with SCD decreased with increasing age (OR = 0.81, 95% CI: 0.70–0.93). Conclusion: Children with SCD referred for PSG are at risk for severe OSA. Compared with the non-SCD group, most children were African American with lower rates of obesity and lower AHIs but longer periods of nocturnal hypoxemia. Likelihood for severe OSA decreased with increasing age for the SCD group. Level of Evidence: 3, retrospective comparative study Laryngoscope, 133:1766–1772, 2023.