Sleep Disorders Common in Sickle Cell Disease

A study published in the Journal of Clinical Sleep Medicine found 44 percent of adults with sickle cell disease also experience sleeping difficulties.

Since patients with sickle cell disease typically aren’t obese and take medications that cause daytime sleepiness, physicians dismiss testing them for sleep apnea, according to the study’s first author, Sunil Sharma, MD, Associate Professor of Pulmonary and Critical Care Medicine, Sidney Kimmel Medical College at Thomas Jefferson University.

For their report, investigators included 32 consecutive adult patients sickle cell disease who underwent a sleep evaluation and overnight polysomnography. To meet the study’s needs, the participants’ Epworth Sleepiness Scale scores, sleep parameters, comorbid conditions, and narcotic use were recorded and compared to patients with and without sleep disordered breathing. The team also weighed the patients’ sickle cell disease complication status.

In doing so, the researchers discovered 44 percent of adult patients with sickle cell disease had either mild or moderate sleep disordered breathing (mean apnea-hypopnea index = 17/h (95 percent CI: 10—24/h). Furthermore 57 percent of participants complained of insomnia and delayed sleep-phase syndrome. They also noted that sickle cell disease complications were not linked to sleeping disorders.

“We wanted to examine the reasons for the sleep disturbances as it can have a strong impact on our patients' quality of life and overall health. We discovered a high incidence of sleep disordered breathing in patients with sickle cell disease, who also report trouble with sleep," Sharma said.

Furthermore, the researchers noted that patients had good oxygen levels during the day but lost oxygen when sleeping. While they believe it is an indication of sleep disordered breathing, more investigation is needed to consider other possible factors.

In a news release that accompanied publication of the study results, Sharma concluded, “Our study suggests that patients with sickle cell disorder should be screened using a questionnaire to identify problems with sleep. For further testing, an oxygen desaturation index is another low-cost screening tool that can identify sleep disordered breathing in this population.”