Abstract
Children with sickle cell disease (SCD) have an increased risk of sleep
disordered breathing (SDB) compared with the general pediatric
population. There has been a growing research interest on this field in
recent years, yet many questions regarding risk factors and clinical
implications of SDB remain unclear. The aim of this review is to provide
a concise narrative and systematic synthesis of the available evidence
on the epidemiology, clinical presentation, complications and
management, of SDB in children with SCD. An electronic search was
conducted on studies published from the 1st of January 2000 to the 31st
of December 2020 in PubMed/Medline, Scopus and Cochrane databases. All
studies focusing on SDB in children with SCD aged from 0 to 20 years
were included. Studies were eligible for inclusion if available in the
English language. A quantitative synthesis of the included studies was
performed. Only studies focusing on specific treatment outcomes were
included in a meta-analytic process. A total of 190 papers were
initially identified. After screening the title and abstract, 112
articles were evaluated for eligibility. At the end of the selection
process, 62 studies were included in the analysis. Sleep-disordered
breathing is associated with worse neurological, neurocognitive and
cardiological outcomes, whereas the association with frequency or
severity of vaso-occlusive pain events and acute chest syndrome was not
clarified. Therapeutic interventions like adenotonsillectomy or oxygen
supply may result in a significant increase in mean nocturnal oxygen
saturation but effective clinical implications remain still unclear.