Correlates of nocturnal hypoxemia in children with sickle cell disease

Abstract Objectives Nocturnal hypoxemia (NH) and obstructive sleep apnea (OSA), more prevalent in children with sickle cell disease, are associated with sickle cell disease-related comorbidities. This study aimed to identify clinical and laboratory factors associated with NH in children with sickle cell disease. Methods This was an institutional review board-approved exploratory retrospective chart review of 81 children with SCD followed by the Sickle Cell Center at St. Christopher’s Hospital for Children, Philadelphia, PA, referred for an overnight polysomnogram 2008-2014. Demographic, hematologic, respiratory, SCD-related comorbidities and therapies, surgical history, and emergent healthcare utilization data were collected. Data were analyzed by IBM SPSS. Bivariate analyses identified clinical variables that were significantly, individually associated with NH. Clinical variables significantly associated with NH in bivariate analyses were entered in logistic regression models with OSA status to identify factors independently associated with NH, adjusting for OSA status. Results Fifteen children (19%) had NH, 18 (22%) had OSA, and 8 (10%) had both. Children with OSA more likely had NH. Lower hemoglobin level, higher reticulocyte count, lower diastolic blood pressure, and lower oxygen saturation were independently, significantly associated with NH, irrespective of the patient’s OSA status. Conclusions NH was present even in the absence of OSA. Identifying factors associated with NH is valuable to guide management of this cohort due to the known complications associated with NH in SCD.