A new study has confirmed the increased risk of obstructive sleep apnea (OSA) in children with sickle cell disease (SCD) and found that this population is at increased risk of severe OSA.

The study, published in The Laryngoscope, also determined that the study participants with SCD had lower rates of obesity and lower mean apnea-hypopnea indices (AHI) than children without SCD, but they also had longer periods of nocturnal hypoxemia.

“A prospective study of children with SCD found [an OSA] prevalence rate of 10% to 40% based on the apnea–hypopnea index (AHI ≥1 and AHI ≥5 respectively), which is higher than the 2% prevalence in the general pediatric population,” the authors wrote. “The primary aim of this study is to compare the demographic, clinical, and polysomnographic characteristics of children with OSA and SCD to a general pediatric population.”

Read more about SCD epidemiology

The research team conducted a retrospective study on 128 children aged 1 to 18 years with SCD and 420 without SCD who were referred to a single center in Dallas, Texas, for polysomnography (PSG) between January 2009 and June 2020. Demographic, clinical, and PSG parameters were collected, including race/ethnicity, body mass index (BMI), AHI, and various additional apnea-related data.

The results revealed that more than 94% of children with SCD had OSA and 43% had severe OSA. The patients with SCD had more severe nocturnal desaturation and more sleep time with oxygen saturation below 90%.

Most of the patients with SCD were African American and the patients in the non-SCD group were mostly Hispanic and White, a finding that was expected given the predominance of SCD among African Americans. African Americans are also known to be at greater risk of OSA.

The authors found that the risk of severe OSA in children with SCD decreased with age, and no association was found with BMI in this group. They recommend increased vigilance and a lower screening threshold for OSA among clinicians treating pediatric patients with SCD.


Abijay CA, Kemper WC, Pham A, Johnson RF, Mitchell RB. Pediatric obstructive sleep apnea and sickle cell disease: demographic and polysomnographic features. Laryngoscope. Published online March 8, 2023. doi:10.1002/lary.30638