Abstract
Introduction: Children with Sickle cell disease (SCD) have a higher prevalence of Obstructive sleep apnea (OSA) and OSA has been identified as an important comorbidity in children with SCD. There evidence linking nocturnal desaturations with an increased rate of both vaso-occlusive episodes (VOE) and acute chest syndrome (ACS).
Methods: In our centre, all children and adolescents with SCD and OSA are evaluated for adenotonsillar hypertrophy, as adenotonsillectomy may be curative in some. Retrospective review of children with SCD who underwent adenotonsillectomyfor OSA between 2004 to 2015. Sleep study data and admission rates due to VOE & ACS were compared, before & after adenotonsillectomy.
Results: 37 children with SCD underwent adenotonsillectomy during this time frame. 22 children (13 male) with a median age of 7 years (range 3-12 years) had sleep study before and after adenotonsillectomy.
| Before | After | P value | |
| Nocturnal oxygen saturations (Sp02) % | 94.4 | 95.0 | 0.412 |
| Overnight nadir oxygen saturations (Sp02) % | 81.0 | 87.0 | 0.002 |
| Nocturnal 3% oxygen desaturation index (ODI) | 5.45 | 2.4 | 0.003 |
| Nocturnal carbon dioxide (pC02) kPa | 6.00 | 5.78 | 0.438 |
| ACS (admissions per year) | 0.59 | 0.23 | 0.254 |
| VOE (admission per year) | 0.45 | 0.50 | 0.922 |
*All values median (range)
Comparison of sleep study results & rate of ACS and VOE in children with SCD who underwent adenotonsillectomy.
Discussion: Children with SCD and OSA, who had adenotonsillectomy, appeared to have a significant increase in overnight nadir oxygen saturations, as well as a reduction in the overnight ODI; but no change in the rates of severe ACS or VOE. Further testing by a randomised controlled trial or prospective longitudinal study is needed.
- Copyright ©the authors 2016
