{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T01:05:19Z","timestamp":1790384719019,"version":"4.1.0"},"reference-count":25,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2018,1,25]],"date-time":"2018-01-25T00:00:00Z","timestamp":1516838400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","award":["NIH 1R01HL079937 (DeBaun)"],"award-info":[{"award-number":["NIH 1R01HL079937 (DeBaun)"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","award":["UL1 RR024989 (CWRU CRU)"],"award-info":[{"award-number":["UL1 RR024989 (CWRU CRU)"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["American J Hematol"],"published-print":{"date-parts":[[2018,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Conflicting evidence has suggested that low mean nocturnal hemoglobin oxygen saturation (SpO<jats:sub>2<\/jats:sub>) predicts future hospital days for acute severe pain in children with sickle cell anemia (SCA). In an unselected multicenter prospective cohort study, we tested the hypothesis that either low mean nocturnal SpO<jats:sub>2<\/jats:sub> or high obstructive apnea\u2010hypopnea index (OAHI; the number of obstructive apneas and hypopneas with\u2009\u2265\u20093% desaturation or arousal per hour of sleep) or high oxygen desaturation index (ODI; number of\u2009\u2265\u20093% desaturation from baseline saturation per hour of sleep) is associated with increased incidence rates of pain. A total of 140 children with SCA with a median age of 10.8 years (interquartile range 7.2) were followed for a median of 4.9 years (interquartile range 1.8). Overnight polysomnography evaluations at baseline health exam were measured and adjudicated centrally. Multivariable models created in two steps were included. First, all plausible covariates were included in a screening model. Subsequently, covariates meeting level of statistical significance of <jats:italic>P<\/jats:italic>\u2009&lt;\u2009.20 were included in the final model. Contrary to our hypothesis, higher (but not lower) mean nocturnal SpO<jats:sub>2<\/jats:sub> was associated with higher rates of pain episodes (Incidence rate ratio (IRR) 1.10, 95% CI [1.03\u20101.18], <jats:italic>P<\/jats:italic>\u2009=\u2009.004). Higher log OAHI did not pass screening criteria. Higher log ODI was not significantly associated with higher rates of pain episodes (IRR 0.93, 95% CI [0.82\u20101.06], <jats:italic>P<\/jats:italic>\u2009=\u2009.28). Neither low nocturnal SpO2, higher OAHI, nor higher ODI were associated with clinically relevant increased incidence rates of acute severe pain episodes.<\/jats:p>","DOI":"10.1002\/ajh.25013","type":"journal-article","created":{"date-parts":[[2017,12,20]],"date-time":"2017-12-20T08:22:37Z","timestamp":1513758157000},"page":"478-485","source":"Crossref","is-referenced-by-count":31,"title":["Sleep disordered breathing does not predict acute severe pain episodes in children with sickle cell anemia"],"prefix":"10.1002","volume":"93","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6691-816X","authenticated-orcid":false,"given":"Shaina M.","family":"Willen","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Division of Hematology\/Oncology Vanderbilt\u2010Meharry Center for Excellence in Sickle Cell Disease, Vanderbilt University Medical Center Nashville Tennessee"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Rodeghier","sequence":"additional","affiliation":[{"name":"Rodeghier Consultants Chicago Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carol L.","family":"Rosen","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Pediatric Pulmonary, Allergy\/Immunology and Sleep University Hospitals\u2010Cleveland Medical Center, Rainbow Babies and Children's Hospitals Cleveland Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0574-1604","authenticated-orcid":false,"given":"Michael R.","family":"DeBaun","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Hematology\/Oncology Vanderbilt\u2010Meharry Center for Excellence in Sickle Cell Disease, Vanderbilt University Medical Center Nashville Tennessee"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,1,25]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(12)61229-X"},{"issue":"22","key":"e_1_2_7_3_1","doi-asserted-by":"crossref","first-page":"902","DOI":"10.1182\/blood.V114.22.902.902","article-title":"Endothelial activation by sickle mouse red cells and their endothelial adhesion in vivo is abolished by catalase treatment of sickle cells, but not quiescent endothelium, implying a role of heme\u2010mediated peroxide generation in sickle cell adhesion","volume":"114","author":"Kaul 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