Comorbidities in sickle cell disease patients with obstructive sleep apnea: a systematic review and meta-analysis

Abstract

Aim: Sickle cell disease (SCD) is a hematologic multisystem disorder. Despite rapid growth in the therapeutic modalities for SCD, it is still considered a life-threatening disorder with high morbidity and mortality rates. This study aims at assessing the prevalence of the comorbidities in patients with SCD with obstructive sleep apnea (OSA). Methods: A computerized search was conducted through six databases. We included all papers that discussed the prevalence of neurological comorbidities in patients with SCD and OSA, whether alone or compared to patients with SCD and without OSA or any comparator. We calculated odds ratios (ORs) with corresponding 95% confidence intervals (95% CI) for stroke rates. Results: Finally, we included six papers for this systematic review. There was a significant increase in stroke odds among the OSA group compared to the non-OSA one (OR = 1.84; 95% CI = 1.18-2.87; p-value = 0.024), with no significant heterogeneity among the included studies (I2 = 36%; p-value = 0.194). Seizure rates showed a significant increase in those with OSA compared to those without it (2.9% vs.1.7%; p-value < 0.001). The TIA and silent cerebral infarct rates were comparable among OSA and non-OSA groups. Conclusion: OSA imposes a risk of neurological comorbidities among SCD patients.