Season 6 | Episode 4


While sleep disorders are associated with numerous health complications, one area that doesn’t receive much attention is the impact of sleep and sleep disorders on those with sickle cell anemia. A study published in Sleep and Breathing found that children with sickle cell disease and comorbid obstructive sleep apnea had 47% more health complications than those with sickle cell disease who had a lower risk for OSA due to negative OSA screenings or exams. These complications seemed to be related to nocturnal hypoxia. Pain from a sickle crisis also can lead to sleep fragmentation. Dr. Sonal Malhotra discusses the many ways in which she tries to optimize sleep for her patients with sickle cell anemia.

Sonal Malhotra, MD, MPH, is a board-certified pediatrician who practices both pediatric pulmonary and sleep medicine at Texas Children’s Hospital in Houston. Her primary clinical interests are respiratory and sleep complications from asthma, sickle cell disease, neuromuscular diseases and obesity.  Dr. Malhotra’s work is based on her passion for being a patient advocate and her dedication to deliver high-quality care through partnership with family members and caregivers. She earned a Master of Public Health and a medical degree from St. George’s University School of Medicine in Grenada, and she completed a pediatrics residency at Albany Medical Center, a pediatric pulmonary fellowship at Ann & Robert H. Lurie Children’s Hospital of Chicago, and a sleep medicine fellowship at Baylor College of Medicine.

Episode Resources

  1. Katz T, Schatz J, Roberts CW. Comorbid obstructive sleep apnea and increased risk for sickle cell disease morbidity. Sleep Breath. 2018;22:797–804.
  2. Melão A. Kids with sickle cell disease and sleep apnea at higher risk of complications, study finds. Sickle Cell Disease News. July 10, 2018. Available at
  3. Ellis JD, Samiei S, Neupane S, et al. Sleep disruption moderates the daily dynamics of affect and pain in sickle cell disease. J Pain. 2024:S1526-5900(24)00352-3.
  4. Taherifard E, Taherifard E, Hosseini-Bensenjan M, Sayadi M, Haghpanah S. The prevalence of obstructive sleep apnea and associated symptoms among patients with sickle cell disease: a systematic review and meta-analysis. Hemoglobin. 2023;47(6):215-226.