Abstract
Study Objectives: Periodic limb movements (PLMs) have been associated with increased risk of stroke, but there is currently scarce research exploring this relationship in the setting of sickle cell disease (SCD). The aim of this study was to explore whether increased PLMs in children with SCD are associated with increased risk of cerebrovascular disease and to determine if there are any clinical or laboratory differences between children with SCD with elevated periodic limb movement index (PLMI) versus those with normal PLMI. Methods: This study is a comprehensive review of medical records of 129 children with SCD (aged ≤ 18 years) who had undergone polysomnography for evaluation of sleep-disordered breathing. Results: Elevated PLMI (PLMI > 5 events/h) was present in 42% (54/129) of children with SCD. Children with elevated PLMI were found to have higher percentage of hemoglobin S, lower total iron, higher arousal index and tendency toward elevated transcranial Doppler velocity (P = .063, odds ratio = 3.9, 95% CI 0.93–16.22). While association between elevated PLMI and isolated cerebrovascular stenosis (P = .050, odds ratio 5.6, 95% CI 1.0–31.10) trended toward significance, there was significantly greater proportion of children with elevated PLMI who had cerebrovascular stenosis with Moyamoya disease (P = .046) as demonstrated by magnetic resonance imaging (MRI). Conclusions: The prevalence of elevated PLMI in children with SCD was higher than in previously published data. Elevated PLMI was significantly associated with greater rates of cerebrovascular disease as detected by MRI.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 1011-1019 |
| Number of pages | 9 |
| Journal | Journal of Clinical Sleep Medicine |
| Volume | 15 |
| Issue number | 7 |
| DOIs | |
| State | Published - Jan 1 2019 |
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Keywords
- Cerebrovascular disease
- Children
- Magnetic resonance imaging
- Periodic limb movements in sleep
- Polysomnography
- Sickle cell disease
- Transcranial doppler
ASJC Scopus subject areas
- Pulmonary and Respiratory Medicine
- Neurology
- Clinical Neurology
Cite this
Association between periodic limb movements in sleep and cerebrovascular changes in children with sickle cell disease. / Lin, Jenny; Morrone, Kerry A.; Manwani, Deepa G.; Chernin, Rina; Silver, Ellen J.; Shifteh, Keivan; Sin, Sanghun; Arens, Raanan; Graw-Panzer, Katharina.
In: Journal of Clinical Sleep Medicine, Vol. 15, No. 7, 01.01.2019, p. 1011-1019.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Association between periodic limb movements in sleep and cerebrovascular changes in children with sickle cell disease
AU - Lin, Jenny
AU - Morrone, Kerry A.
AU - Manwani, Deepa G.
AU - Chernin, Rina
AU - Silver, Ellen J.
AU - Shifteh, Keivan
AU - Sin, Sanghun
AU - Arens, Raanan
AU - Graw-Panzer, Katharina
PY - 2019/1/1
Y1 - 2019/1/1
N2 - Study Objectives: Periodic limb movements (PLMs) have been associated with increased risk of stroke, but there is currently scarce research exploring this relationship in the setting of sickle cell disease (SCD). The aim of this study was to explore whether increased PLMs in children with SCD are associated with increased risk of cerebrovascular disease and to determine if there are any clinical or laboratory differences between children with SCD with elevated periodic limb movement index (PLMI) versus those with normal PLMI. Methods: This study is a comprehensive review of medical records of 129 children with SCD (aged ≤ 18 years) who had undergone polysomnography for evaluation of sleep-disordered breathing. Results: Elevated PLMI (PLMI > 5 events/h) was present in 42% (54/129) of children with SCD. Children with elevated PLMI were found to have higher percentage of hemoglobin S, lower total iron, higher arousal index and tendency toward elevated transcranial Doppler velocity (P = .063, odds ratio = 3.9, 95% CI 0.93–16.22). While association between elevated PLMI and isolated cerebrovascular stenosis (P = .050, odds ratio 5.6, 95% CI 1.0–31.10) trended toward significance, there was significantly greater proportion of children with elevated PLMI who had cerebrovascular stenosis with Moyamoya disease (P = .046) as demonstrated by magnetic resonance imaging (MRI). Conclusions: The prevalence of elevated PLMI in children with SCD was higher than in previously published data. Elevated PLMI was significantly associated with greater rates of cerebrovascular disease as detected by MRI.
AB - Study Objectives: Periodic limb movements (PLMs) have been associated with increased risk of stroke, but there is currently scarce research exploring this relationship in the setting of sickle cell disease (SCD). The aim of this study was to explore whether increased PLMs in children with SCD are associated with increased risk of cerebrovascular disease and to determine if there are any clinical or laboratory differences between children with SCD with elevated periodic limb movement index (PLMI) versus those with normal PLMI. Methods: This study is a comprehensive review of medical records of 129 children with SCD (aged ≤ 18 years) who had undergone polysomnography for evaluation of sleep-disordered breathing. Results: Elevated PLMI (PLMI > 5 events/h) was present in 42% (54/129) of children with SCD. Children with elevated PLMI were found to have higher percentage of hemoglobin S, lower total iron, higher arousal index and tendency toward elevated transcranial Doppler velocity (P = .063, odds ratio = 3.9, 95% CI 0.93–16.22). While association between elevated PLMI and isolated cerebrovascular stenosis (P = .050, odds ratio 5.6, 95% CI 1.0–31.10) trended toward significance, there was significantly greater proportion of children with elevated PLMI who had cerebrovascular stenosis with Moyamoya disease (P = .046) as demonstrated by magnetic resonance imaging (MRI). Conclusions: The prevalence of elevated PLMI in children with SCD was higher than in previously published data. Elevated PLMI was significantly associated with greater rates of cerebrovascular disease as detected by MRI.
KW - Cerebrovascular disease
KW - Children
KW - Magnetic resonance imaging
KW - Periodic limb movements in sleep
KW - Polysomnography
KW - Sickle cell disease
KW - Transcranial doppler
UR - http://www.scopus.com/inward/record.url?scp=85069057280&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85069057280&partnerID=8YFLogxK
U2 - 10.5664/jcsm.7884
DO - 10.5664/jcsm.7884
M3 - Article
C2 - 31383239
AN - SCOPUS:85069057280
VL - 15
SP - 1011
EP - 1019
JO - Journal of Clinical Sleep Medicine
JF - Journal of Clinical Sleep Medicine
SN - 1550-9389
IS - 7
ER -