Sleep Disorders in Adult Sickle Cell Patients

Sharma, Sunil; Efird, Jimmy T.; Knupp, Charles; Kadali, Renuka; Liles, Darla; Shiue, Kristin Y.; Boettger, Peter; Quan, Stuart F.

doi:10.5664/jcsm.4530

Cited by 54 publications

(36 citation statements)

References 20 publications

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“…Sharma et al identified obstructive sleep apnea in 44% of in 32 adult SCD patients (mean AHI 17 events/hour, (95% CI: 10–24/h) who had been referred to a sleep center based upon SDB symptoms [10], yet no studies have been undertaken to evaluate SDB in the absence of symptoms. Here we report a pilot study to evaluate the frequency and severity of SDB in clinically stable young adults with SCD with no previously identified symptoms of sleep disturbance, cardiac, or pulmonary vascular disease.…”

Section: Introductionmentioning

confidence: 99%

Sleep-disordered breathing and nocturnal hypoxemia in young adults with sickle cell disease

et al. 2016

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Sleep disordered breathing (SDB) is reported in up to 69% of adolescents and children with sickle cell disease (SCD) [1], but data regarding the prevalence of SDB in adults with SCD are limited. To obtain a preliminary assessment of the frequency and degree of sleep-related hypoxemia and potential associations with cardiovascular function in adults with SCD, we performed overnight sleep studies, 6-minute walk tests, echocardiograms, hematologic and chemistry panels, and administered the Pittsburgh Sleep Quality Index (PSQI), fatigue and health related quality of life measurement in 20 young adults with SCD attending a sickle cell clinic for routine care. Sleep apnea, defined as an apnea-hypopnea index (AHI) >5 events/hour, was found in 50% of subjects. Traditional clinical indicators such as obesity, the presence of snoring, and reported sleep complaints did not reliably differentiate these subjects. Subjects with an AHI>5 had higher mean systolic blood pressure (p =.03), evidence of impaired left ventricular diastolic function (i.e. increased mitral valve E/A ratio, p =.05), a trend toward greater reduction in 6 minute walk distances (p =.06), and lower Health-related Quality of Life scores (p <=.01). Three of nine subjects with more severe anemia (total Hb < 9.0) demonstrated nocturnal hypoxemia in the absence of sleep apnea. As prolonged and frequent hypoxemic episodes likely increase risks for vaso-occlusive, cardiovascular, and neurologic complications of SCD, these results suggest that the prevalence and severity of SDB should be investigated further in studies of larger patient populations. If confirmed, these findings could identify opportunities to prevent or reduce nocturnal hypoxia and improve outcomes.

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Section: Introductionmentioning

confidence: 99%

Sleep-disordered breathing and nocturnal hypoxemia in young adults with sickle cell disease

et al. 2016

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“…We did not evaluate sleep complaints, and so we were unable to diagnose PLMD, although Sharma et al (2015) did not observe PLMD in their study. We could not evaluate night-to-night variability of PLMS, due to technical conditions.…”

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confidence: 89%

“…Roizenblatt et al (2012) noted an association between PLMS and history of priapism in a group of 34 adults with SCD. In turn, Sharma et al (2015) reported absence of PLMD in 39 adults (Sharma et al, 2015).…”

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confidence: 96%

“…High PLMS indexes are associated with dopaminergic disorders. However, few studies on PLMS in adults have been published (Roizenblatt et al, 2012;Sharma et al, 2015). However, nonspecific changes have been demonstrated, such as in relation to heart rate and blood pressure (Hornyak et al, 2006).…”

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confidence: 99%

“…PLMS has been correlated with attention deficit disorder and restless leg syndrome in SCD children (Rogers et al, 2011). Sleep disorders also seem to be important in adults with SCD, but only two studies have made any observations in relation to PLMS (Roizenblatt et al, 2012;Sharma et al, 2015). Roizenblatt et al (2012) noted an association between PLMS and history of priapism in a group of 34 adults with SCD.…”

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confidence: 99%

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Periodic limb movement in sleep and sickle cell disease: a neglected association?

et al. 2017

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High frequency of periodic limb movements in sleep (PLMS) has been described among children with sickle cell disease (SCD), but there is little information about PLMS among adults with SCD. We aim to determine the frequency of PLMS among adults with SCD and to identify possible associations with iron status and haemolytic parameters. We analysed polysomnography on 99 adults: 74 with sickle cell anaemia (HbSS), 19 with HbSC (double heterozygosis HbS and HbC) and 6 with HbS-beta thalassaemia. Laboratory data were collected close to the time of the polysomnography examination. The prevalence of PLMS > 5/h was 70% and of PLMS > 15/h 36%, in the total group of patients. No differences were observed regarding gender, use of hydroxyurea and iron parameters. Logistic regression showed an association between PLMS > 15/h and hemolytic parameters: absolute reticulocyte count (p = 0.03) and unconjugated bilirubin (p = 0.01). Our data suggest that PLMS may be associated with manifestations of greater severity in SCD.

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Nocturnal hemoglobin desaturation is associated with reticulocytosis in adults with sickle cell disease and is independent of obstructive sleep apnea

et al. 2016

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Sleep Disorders in Adult Sickle Cell Patients

Abstract: A high burden of sleep disordered breathing and other sleep-related complaints were identified in the adult sickle cell population. Our results provide important information on this unique population.

Cited by 54 publications

References 20 publications

Sleep-disordered breathing and nocturnal hypoxemia in young adults with sickle cell disease

Sleep-disordered breathing and nocturnal hypoxemia in young adults with sickle cell disease

Periodic limb movement in sleep and sickle cell disease: a neglected association?

Nocturnal hemoglobin desaturation is associated with reticulocytosis in adults with sickle cell disease and is independent of obstructive sleep apnea

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