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Sleep disturbance in adults with sickle cell disease: relationships with executive and psychological functioning


Sleep disturbance is common among children with sickle cell disease (SCD) and is related to neurocognitive difficulties. However, research on sleep disturbances and related variables among adults with SCD is extremely limited. The present study examined the relationship between sleep, executive functioning, and emotional functioning among 62 adults (29 females; M age = 32 years, SD = 7.79) with SCD preparing to undergo a stem cell transplant. Participants were administered a neurocognitive evaluation that included objective and subjective measures of executive functioning, and they completed PROMIS self-report measures of anxiety, depression, and pain intensity. Results showed that about 17% of participants endorsed clinically significant sleep disruptions, while 16.1% and 8% endorsed clinically significant symptoms of anxiety and depression, respectively. Sleep disturbance in these adults was not significantly correlated with objective or subjective measures of executive functioning. Moreover, anxiety, but not depression, was a significant mediator between self-reported sleep difficulties and both objective and subjective measures of executive functioning while controlling for pain intensity. Future research on sleep interventions will be essential for ameliorating the effects of sleep disturbance on executive functioning and anxiety among adults with SCD.

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Data availability

The data included in the study is not publicaly available according to the NIH Publishing Agreement.


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The authors are grateful to the patients who participated in this study. The content of this publication does not necessarily reflect the views or policies of the Department of Health and Human Services nor does mention of trade names, commercial products, or organizations imply endorsement by the U.S. Government.


This work was funded, in part, by the NCI Center for Cancer Research IRP. This project has been funded in whole or in part with federal funds from the National Cancer Institute, National Institutes of Health, under Contract No. HHSN261200800001E.

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Correspondence to Staci Martin.

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The authors declare that they have no conflict of interest.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional review board and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The study was approved by the National Heart Lung and Blood Institute (Protocol Numbers: 09-H-0225, 03-H-0170, 14-H-0077, 17-H-0069).

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Rhodes, A., Martin, S., Wolters, P. et al. Sleep disturbance in adults with sickle cell disease: relationships with executive and psychological functioning. Ann Hematol 99, 2057–2064 (2020).

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  • Sickle cell disease
  • Sleep
  • Executive functioning
  • Anxiety
  • Depression