Sickle Cell Disease In Adults Who Also Have Sleep Disordered Breathing Is Relatively Common

New findings published in the Journal of Clinical Sleep Medicine show that sickle cell disease is troublingly high among adults who report trouble sleeping and who typically report a clinical diagnosis of sleep disordered breathing, including sleep apnea, which can significantly distress oxygen levels at night.

"Previous research identified pain and sleep disturbance as two common symptoms of adult sickle cell disorder," said Sunil Sharma, M.D., Associate Professor of Pulmonary and Critical Care Medicine, Sidney Kimmel Medical College at Thomas Jefferson University and first author on the study, in a news release. "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."

Researchers theorized that the diagnosis of sleep disordered breathing could be missed in the population as adults with sickle cell disease are not necessarily obese, which is a typically factor related to sleep apnea (though not always.) 

In future studies, they hope the study will increase awareness among physicians who can screen for sleep disordered breathing in adults with the health issue, that is oftentimes missed. 

"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," said Dr. Sharma.

"Sleep disordered breathing is of particular concern in patients with sickle cell disease since it may lead to nighttime hypoxia," said Elizabeth Pulte, M.D., Assistant Professor of Hematology, Cardeza Foundation for Hematologic Research and Director of Jefferson's Comprehensive Sickle Cell Disease Program. "Hypoxia induces sickling in sickle red blood cells. So, any condition that increases hypoxia increases the risk of sickling and crisis pain. I plan to screen patients in my practice for sleep disturbances and refer them to the sleep lab if they have symptoms suggestive of sleep apnea or related disorders."

Due to sleep disordered breathing, the patients seemed to maintain good sleep breathing during the day. However, at night, they had significant oxygen loss, which was the result of numerous factors. Future studies will help to examine the health issue further.