Abstract
PurposePatients with sickle cell disease (SCD) regularly experience abnormal sleep, characterized by frequent arousals and reduced total sleep time. However, obstructive sleep apnea syndrome (OSAS) is a common comorbidity of SCD, making it unclear whether the disease per se is impacting sleep, or sleep disruption is secondary to the presence of OSAS. Thus, we assessed sleep, independent of OSAS, using a mouse model of SCD.MethodsSleep was compared between 10-to-12-week-old Townes knockout-transgenic mice with the sickle cell phenotype SS (n = 6) and Townes mice with sickle cell trait AS (n = 6; control). The mice underwent chronic polysomnographic electrode implantation (4EEG/2EMG) to assess sleep architecture.ResultsThe SS mice had significantly lower hemoglobin concentration compared to control AS mice (7.3 ± 1.3 vs. 12.9 ± 1.7 g/dL; p < 0.01), consistent with the expected SCD phenotype. SS mice exhibited significantly decreased total NREM sleep time (45.0 ± 0.7 vs. 53.0 ± 1.3% 24 h sleep time; p < 0.01), but no change in total REM sleep time compared to the AS mice. The SS mice took longer to resume sleep after a wake period compared to the AS mice (3.2 ± 0.3 min vs. 1.9 ± 0.2 min; p < 0.05). Unexpectedly, SS mice experienced fewer arousals compared to AS mice (19.0 ± 0.9 vs. 23.3 ± 2.1 arousals/h of sleep; p = 0.031).ConclusionsThe presence of decreased total NREM sleep associated with reduced arousals, in the absence of OSAS, suggests a distinctive underlying sleep phenotype in a mouse model of SCD.
Highlights
Sickle cell disease (SCD) is one of the most prevalent hemoglobinopathies in the USA with roughly 1 in 350 newborns in the African-American population affected [1]
The presence of decreased total non-rapid eye movement (NREM) sleep associated with reduced arousals, in the absence of obstructive sleep apnea syndrome (OSAS), suggests a distinctive underlying sleep phenotype in a mouse model of sickle cell disease (SCD)
Little is known about sleep in SCD patients, and what is known is confounded by multiple comorbidities associated with the disease, including a high prevalence of OSAS
Summary
Experiments were conducted in adult male 10-to-12-week-old Townes knockout-transgenic SS and AS sickle cell mice on a background strain of B6 and S129. All mice underwent surgical implantation of polysomnographic electrodes on day 0 and were tethered to the recording system after 7 days of recovery. On day 11, after 4 days of undisturbed acclimation to the tether, electroencephalographic (EEG) and electromyographic (EMG) signals were recorded for a continuous 24-h period. The polysomnographic tether and arterial catheter (in the subset of instrumented mice) exited through a 1′′-diameter hole in the top of the chamber, and connected to an amplifier and a multi-syringe pump, respectively. The program utilizes Fourier spectral analysis of the EEG in the delta (0.5–4.0 Hz), sigma (10.0– 14.0 Hz), and theta (6.0–9.0 Hz) frequency bands in combination with the moving average of the EMG amplitude to assess sleep/wake states in 10-s epochs (necessary to provide accurate determination of the beginning and end of REM sleep bouts that typically average around 1 min). Statistical differences between groups were determined by two-way unpaired Student’s t test
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