Hostname: page-component-586b7cd67f-dsjbd Total loading time: 0 Render date: 2024-11-26T21:02:57.223Z Has data issue: false hasContentIssue false
  • English
  • Français

Nocturnal Oxygen Desaturation and Disordered Sleep as a Potential Factor in Executive Dysfunction in Sickle Cell Anemia

Published online by Cambridge University Press:  24 November 2011

Matthew J. Hollocks ,
Tessa B. Kok ,
Fenella J. Kirkham ,
Johanna Gavlak ,
Baba P. Inusa ,
Michael R. DeBaun  and
Michelle de Haan
Matthew J. Hollocks*
Affiliation:
Neurosciences & Mental Health, Institute of Child Health, University College London, London, United Kingdom
Tessa B. Kok
Affiliation:
Neurosciences & Mental Health, Institute of Child Health, University College London, London, United Kingdom
Fenella J. Kirkham
Affiliation:
Neurosciences & Mental Health, Institute of Child Health, University College London, London, United Kingdom
Johanna Gavlak
Affiliation:
Portex Unit, Institute of Child Health, University College London, London, United Kingdom
Baba P. Inusa
Affiliation:
Evelina Children's Hospital, Guy's and St Thomas Hospital, London, United Kingdom
Michael R. DeBaun
Affiliation:
Department of Pediatrics, Vanderbilt University, Nashville, Tennessee
Michelle de Haan
Affiliation:
Neurosciences & Mental Health, Institute of Child Health, University College London, London, United Kingdom
*
Correspondence and reprint requests to: Matthew J. Hollocks, Department of Child & Adolescent Psychiatry PO85, Institute of Psychiatry, DeCrespigny Park, Denmark Hill, London, United Kingdom SE5 8AF. E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Previous research has identified cognitive impairment in children with sickle cell anemia (SCA, Hemoglobin SS) compared with controls, partly accounted for by overt neuropathology after clinical stroke, “covert” (“silent”) infarction, and severity of anemia. However, cognitive deficits have also been identified in children with SCA with no history of stroke and a normal T2-weighted magnetic resonance imaging (MRI) scan. Our aim was to investigate whether nocturnal hemoglobin oxygen desaturation and sleep fragmentation could be associated with cognitive impairment in children with SCA. We assessed 10 children with SCA (9 with normal MRI) using neuropsychological measures of executive function. Cognitive assessment was immediately followed by overnight polysomnography to record nocturnal hemoglobin oxygen saturation and sleep arousals. Decreases in hemoglobin oxygen saturation and/or increased sleep arousals were associated with reduced performance on cognitive assessment. Nocturnal hemoglobin oxygen desaturation and sleep fragmentation may be a contributing factor to executive dysfunction in SCA. (JINS, 2012, 18, 168–173)

Keywords

AnemiaSickle cellIntelligenceNeuropsychologyOximetrySleep arousal disordersPolysomnography
Type
Brief Communications
Information
Journal of the International Neuropsychological Society , Volume 18 , Issue 1 , January 2012 , pp. 168 - 173
Copyright
Copyright © The International Neuropsychological Society 2011

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Beebe, D.W., Gozal, D. (2002). Obstructive sleep apnea and the prefrontal cortex: Towards a comprehensive model linking nocturnal upper airway obstruction to daytime cognitive and behavioral deficits. Journal of Sleep Research, 11(1), 1–16.CrossRefGoogle ScholarPubMed
Bourke, R.S., Anderson, V., Yang, J.S., Jackman, A.R., Killedar, A., Nixon, G.M., Horne, R.S. (2011). Neurobehavioral function is impaired in children with all severities of sleep disordered breathing. Sleep Medicine, 12(3), 222–229.CrossRefGoogle ScholarPubMed
Casella, J.F., King, A.A., Barton, B., White, D.A., Noetzel, M.J., Ichord, R.N., DeBaun, M.R. (2010). Design of the silent cerebral infarct transfusion (SIT) trial. Pediatric Hematology/Oncology, 27(2), 69–89.CrossRefGoogle ScholarPubMed
Delis, D.C., Kaplan, E., Kramer, J.H. (2001). Examiner's manual for the Delis Kaplan Executive Function System. San Antonio, TX: The Psychological Corporation.Google Scholar
Gioia, G.A., Isquith, P.K., Guy, S., Kenworthy, L. (2000). BRIEF: Behaviour Rating Inventory of Executive Functions manual. Lutz, FL: Psychological Assessment Resources.Google Scholar
Gold, J.I., Johnson, C.B., Treadwell, M.J., Hans, N., Vichinsky, E. (2008). Detection and assessment of stroke in patients with sickle cell disease: Neuropsychological functioning and magnetic resonance imaging. Pediatric Hematology and Oncology, 25, 409–421.CrossRefGoogle ScholarPubMed
Johnson, M.C., Kirkham, F.J., Redline, S., Rosen, C.L., Yan, Y., Roberts, I., DeBaun, M.R. (2010). Left ventricular hypertrophy and diastolic dysfunction in children with sickle cell disease are related to asleep and waking oxygen desaturation. Blood, 116(1), 16–21.CrossRefGoogle ScholarPubMed
Johnston, R.V., Grant, D.A., Wilkinson, M.H., Walker, A.M. (1998). Repetitive hypoxia rapidly depresses arousal from active sleep in newborn lambs. Journal of Physiology, 510(2), 651–659.CrossRefGoogle ScholarPubMed
Kral, M.C., Brown, R.T., Nietert, P.J., Abboud, M.R., Jackson, S.M., Hynd, G.W. (2003). Transcranial doppler ultrasonography and neurocognitive functioning in children with sickle cell disease. Pediatrics, 12(2), 324–331.CrossRefGoogle Scholar
Muzur, A., Pace-Schott, E.F., Hobson, J.A. (2002). The prefrontal cortex in sleep. Trends in Cognitive Science, 6, 475–481.CrossRefGoogle ScholarPubMed
Needleman, J.P., Franco, M.E., Varlotta, L., Reber-Brodecki, D., Bauer, N., Dampier, C., Allen, J.L. (1999). Mechanisms of nocturnal oxyhemoglobin desaturation in children and adolescents with sickle cell disease. Pediatric Pulmonology, 28(6), 418–422.3.0.CO;2-D>CrossRefGoogle ScholarPubMed
Rothman, S.M., Fulling, K.H., Nelson, J.S. (1986). Sickle cell anemia and central nervous system infarction: A neuropathological study. Annals of Neurology, 20, 684–690.CrossRefGoogle ScholarPubMed
Schatz, J.R., Brown, R.T., Pascual, J.M., Hsu, L., DeBaun, M.R. (2001). Poor school and cognitive functioning with silent cerebral infarcts and sickle cell disease. Neurology, 56(8), 1109–1111.CrossRefGoogle ScholarPubMed
Schatz, J., Finke, R.L., Kellett, J.M., Kramer, J.H. (2002). Cognitive functioning in children with sickle cell disease: A meta-analysis. Journal of Pediatric Psychology, 27(8), 739–748.CrossRefGoogle ScholarPubMed
Schatz, J., McClellan, C.B. (2006). Sickle cell disease as a neurodevelopmental disorder. Mental Retardation & Developmental Disabilities Research Review, 12, 200–207.CrossRefGoogle ScholarPubMed
Steen, R.G., Fineberg-Buchner, C., Hankins, G., Weiss, L., Prifitera, A., Mulhern, R.K. (2005). Cognitive deficits in children with sickle cell disease. Journal of Child Neurology, 20, 102–107.CrossRefGoogle ScholarPubMed
Traeger, N., Schultz, B., Pollock, A.N., Mason, T., Marcus, C.L., Arens, R. (2005). Polysomnographic values in children 2-9 years old: Additional data and review of the literature. Pediatric Pulmonology, 40, 22–30.CrossRefGoogle ScholarPubMed
Uliel, S., Tauman, R., Greenfeld, M., Sivan, Y. (2004). Normal polysomnographic respiratory values in children and adolescents. Chest, 125, 872–878.CrossRefGoogle ScholarPubMed
Waters, F., Bucks, R.S. (2011). Neuropsychological effects of sleep loss: Implication for neuropsychologists. Journal of the International Neuropsychological Society, 17, 571–586.CrossRefGoogle ScholarPubMed
Wechsler, D. (1999). Wechsler scale of intelligence manual (trans). San Antonio, TX: Harcourt Brace & Company.Google Scholar