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The association between obstructive sleep apnea and stroke in sickle-cell disease children

  • Laryngology
  • Published:
European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

Introduction

The prevalence of stroke in SCD patients was reported to be around 4%; however, the pediatric category was among the higher risk group for stroke compared to young and middle age adults. Furthermore, the risk of OSA increases in SCD children. The objective of this study is to calculate the prevalence of stroke in children with SCD with and without obstructive sleep apnea.

Method

This is a cross-sectional study held at two major tertiary hospitals in Jeddah, Saudi Arabia. Inclusion criteria included patients aged between 2 and 18 at the time of enrollment with confirmed SCD. The primary outcome of the study was at least one documented episode of stroke over the last 3 years. OSA was assessed using PSQ.

Results

A total of 150 children with SCD were included in the study. The mean age was 9.6 (±4.3). Most of the sample (85.3%) were sickle-cell anemia with HbSS. Children who were positive for OSA were at higher odds of having a stroke [OR 2.97; 95% CI 1.13–7.75 (P = 0.02)]. The relationship between OSA and stroke was not significant in the multivariant analysis.

Conclusion

Patients who had OSA had a higher prevalence of stroke compared to non-OSA patients by 16% with almost three times higher odds. The difference was statistically significant in bivariant but not multivariant analysis. The rate of hospitalization, emergency visit, and blood transfusion were not affected by OSA status. Screening for OSA in high-risk patients such as SCD children and early management could prevent the risk of SCD complications.

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Availability of data and materials

All study is available upon request.

Code availability

STATA version 20.

Abbreviations

SCD:

Sickle cell disease

OSA:

Obstructive sleep apnea

PSQ:

Pediatric sleep questionnaire

PSG:

Polysomnography

CVA:

Cerebral vascular accident

Hb:

Hemoglobin

AHI:

Apnea/Hypopnea Index

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Funding

This project had not been funded by any organization.

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Authors and Affiliations

  1. King Abdulaziz University, 7239 Ahmad Zaynal, As Salamah District, Jeddah, Saudi Arabia

    Albraa Abulhamail

  2. King Khalid National Guard Hospital, Jeddah, Saudi Arabia

    Saif Selati & Rakan Alasqah

Authors
  1. Albraa Abulhamail
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  2. Saif Selati
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  3. Rakan Alasqah
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Correspondence to Albraa Abulhamail.

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I approve that I and other authors have no conflict of interest producing this work. No personal benefits will be gained publishing this paper.

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The project was approved by the unit of biological ethics in the Faculty of Medicine at King Abdulaziz University.

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Abulhamail, A., Selati, S. & Alasqah, R. The association between obstructive sleep apnea and stroke in sickle-cell disease children. Eur Arch Otorhinolaryngol 279, 843–851 (2022). https://doi.org/10.1007/s00405-021-07125-5

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  • DOI: https://doi.org/10.1007/s00405-021-07125-5

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