{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T15:25:31Z","timestamp":1786116331055,"version":"build-2736575974"},"reference-count":25,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T00:00:00Z","timestamp":1784678400000},"content-version":"vor","delay-in-days":21,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Pulmonology"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Though children with sickle cell anemia (SCA) possess an elevated risk for sleep\u2010disordered breathing (SDB), progression of obstructive sleep apnea (OSA) across childhood and optimal screening approach remain unclear. Improved understanding of SDB symptomatology and relationship to OSA may simplify screening. This study longitudinally describes SDB symptom profile in children with SCA and examines how they evolve in relation to upper\u2010airway anatomy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Patients with SCA aged 2\u201318 years were prospectively recruited. Demographic data, clinical assessments, and upper airway examinations were obtained. OSA symptoms were compared to polysomnography (PSG) outcomes and anatomical features.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Habitual snoring was the most common symptom (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200955\/153;36%). Among PSG\u2010qualifying participants (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200992\/153;60%), most exhibited overlapping symptoms (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200954\/92;58.7%), of which 78% co\u2010occurred with habitual snoring. Remaining single qualifying SDB symptoms included habitual snoring (14.1%) vs others (27.2%). PSG performed in 49\/92 (53.3%) children confirmed 23 OSA cases; 19 (82.6%) with habitual snoring, 3 (13%) mouth breathing, and 1 (4.3%) stroke. Habitual snoring but not other SDB symptoms was associated with OSA (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.017). Tonsillar hypertrophy (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.003) and higher Mallampati scores (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.041) predicted habitual snoring. Although habitual snoring prevalence and mean upper\u2010airway anatomical measures cross\u2010sectionally appeared stable (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.602), dynamic longitudinal interactions were observed. New\u2010onset snoring among baseline non\u2010snorers (27.9%) was associated with larger tonsils, whereas snoring resolution in habitual snorers (40.4%) was associated with lower Mallampati scores.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In SCA, habitual snoring as opposed to other symptoms is a practical clinical indicator for the preliminary assessment of OSA. Emergence and resolution of habitual snoring reflect dynamic upper\u2010airway anatomical changes, underscoring importance of periodic reassessments.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ppul.71745","type":"journal-article","created":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T06:58:05Z","timestamp":1784789885000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Natural History of Snoring in Children With Sickle Cell Anemia in Relation to Upper Airway Anatomy and OSA"],"prefix":"10.1002","volume":"61","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-2371-3916","authenticated-orcid":false,"given":"Mariam Z.","family":"Quraishi","sequence":"first","affiliation":[{"name":"CUNY School of Medicine, New York  NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diana","family":"Larrain","sequence":"additional","affiliation":[{"name":"Department of Pediatrics McGovern Medical School at the University of Texas Health Science Center at Houston (UTHealth Houston) Houston TX USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neethu M.","family":"Menon","sequence":"additional","affiliation":[{"name":"Department of Pediatrics McGovern Medical School at the University of Texas Health Science Center at Houston (UTHealth Houston) Houston TX USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deborah L.","family":"Brown","sequence":"additional","affiliation":[{"name":"Department of Pediatrics McGovern Medical School at the University of Texas Health Science Center at Houston (UTHealth Houston) Houston TX USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lakshmi","family":"Srivaths","sequence":"additional","affiliation":[{"name":"Department of Pediatrics McGovern Medical School at the University of Texas Health Science Center at Houston (UTHealth Houston) Houston TX USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hina","family":"Emmanuel","sequence":"additional","affiliation":[{"name":"Department of Pediatrics McGovern Medical School at the University of Texas Health Science Center at Houston (UTHealth Houston) Houston TX USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cindy K.","family":"Jon","sequence":"additional","affiliation":[{"name":"Department of Pediatrics McGovern Medical School at the University of Texas Health Science Center at Houston (UTHealth Houston) Houston TX USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kok Hoe","family":"Chan","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine McGovern Medical School at the University of Texas Health Science Center at Houston (UTHealth Houston) Houston TX USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Trinh T.","family":"Nguyen","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Baylor College of Medicine Houston TX USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aravind","family":"Yadav","sequence":"additional","affiliation":[{"name":"Department of Pediatrics McGovern Medical School at the University of Texas Health Science Center at Houston (UTHealth Houston) Houston TX USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,22]]},"reference":[{"key":"e_1_2_10_2_1","unstructured":"National Heart Lung and Blood Institute Evidence\u2010Based Management of Sickle Cell Disease: Expert Panel Report 2014. 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