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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]
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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

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