Department of Psychology, University of Alabama at Birmingham, Birmingham, AL, USA.
Department of Pediatrics, Division of Pediatric Pulmonary & Sleep Medicine, School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA.
Sleep Med. 2022 Sep;97:27-35. doi: 10.1016/j.sleep.2022.05.015. Epub 2022 May 26.
Youth with sickle cell disease (SCD) without neurological complications continue to be at increased risk of neurocognitive difficulties. Nocturnal hypoxemia is associated with neurocognitive outcomes and has been identified as a chronic complication in youth with SCD. The objective of this study was to assess the relationship between sleep disturbances and neurocognitive functioning in youth with SCD, while taking into account demographic and socioeconomic factors.
Youth with SCD were identified through retrospective chart review who underwent a standardized polysomnography (PSG) and completed a neuropsychological testing battery to assess cognitive skills, including verbal comprehension, working memory, processing speed, and cognitive flexibility. Questionnaires were also collected to assess parent-reported concerns with their youth's executive and adaptive skills.
Twenty-seven youth with SCD, ages 6-17, were identified who completed both a PSG and neuropsychological testing. Results demonstrated that verbal comprehension decreased by 2.37 standard points for every unit decrease in mean nocturnal oxygen saturation (SpO2) (p = 0.031). Working memory was also found to decrease by 1.46 standard points for each 1% increase in time spent under 90% oxygen saturation (pTST SpO2 < 90%) (p = 0.030). Sleep parameters did not significantly predict other cognitive scores or parent-reported executive or behavioral ratings.
Our study found that sleep disturbance, mean nocturnal SpO2 and pTST SpO2 < 90%, significantly affected verbal comprehension and working memory performance, respectively. Overall, these findings have the potential to identify sleep needs in youth with SCD to promote sleep-targeted interventions as a modifiable factor to reduce neurocognitive deficits.
无神经系统并发症的镰状细胞病（SCD）青年患者仍存在认知功能障碍的风险增加。夜间低氧血症与认知结果相关，并已被确定为 SCD 青年患者的慢性并发症。本研究旨在评估 SCD 青年患者的睡眠障碍与神经认知功能之间的关系，同时考虑人口统计学和社会经济因素。
通过回顾性病历审查确定 SCD 青年患者，他们接受了标准化多导睡眠图（PSG）检查，并完成了神经心理学测试套件，以评估认知技能，包括言语理解、工作记忆、处理速度和认知灵活性。还收集了问卷，以评估父母对其青少年执行和适应技能的担忧。
确定了 27 名完成 PSG 和神经心理学测试的 SCD 青年患者。结果表明，平均夜间血氧饱和度（SpO2）每下降一个单位，言语理解能力下降 2.37 个标准点（p=0.031）。工作记忆也发现，SpO2 低于 90%的时间每增加 1%，下降 1.46 个标准点（pTST SpO2<90%）（p=0.030）。睡眠参数与其他认知评分或父母报告的执行或行为评分无显著相关性。
我们的研究发现，睡眠障碍、平均夜间 SpO2 和 pTST SpO2<90%，分别显著影响言语理解和工作记忆表现。总的来说，这些发现有可能确定 SCD 青年的睡眠需求，以促进以睡眠为目标的干预措施，作为可改变的因素来减少神经认知缺陷。
