Sleep Problem Risk for Adolescents With Sickle Cell Disease: Sociodemographic, Physical, and Disease-related Correlates.

The aims of the current study were to investigate whether SCD incurs an additional risk for poor sleep over and above the influence of sociodemographic factors (ie, race and sex) during adolescence, and to explore the relationships between sociodemographic, physical (ie, age and pubertal status), and disease-related factors (ie, SCD genotype and hydroxyurea use) on sleep problem risk during adolescence. Black adolescents (age, 12 to 17 y) with SCD (n=53) were recruited from regional pediatric SCD clinics in the southeast and a sample of healthy black adolescents (n=160) were recruited from middle and high schools. Regression analyses indicated that SCD was uniquely related to sleeping more, and worse sleep quality over and above the influence of sociodemographic factors. Having a more severe SCD genotype was related to worse sleep quality and higher pubertal status was related to sleeping longer during the week. Results indicate the need for systematic assessments of sleep problems, with more a focus on youth with more severe genotypes and higher pubertal status. Future research should focus on characterizing trajectories of sleep problems in this population, identifying key risk factors, and elucidating mechanisms linking risk factors to sleep problem risk to aid in tailoring interventions for this population.

Risk and resilience factors for grade retention in youth with sickle cell disease.

BACKGROUND: Youth with sickle cell disease (SCD) are at higher risk for grade retention than healthy peers. This is salient because research suggests grade retention is ineffective and places youth at additional risk for negative outcomes. The aims of the present study were to identify possible risk factors for grade retention in youth with SCD and to examine positive family functioning as a possible resilience factor. PROCEDURE: Data were extracted from phase 3 of the Cooperative Study of Sickle Cell Disease, a multisite, longitudinal study of individuals with SCD. Participants were 370 youth, aged 6-16 years, with complete data on history of grade retention. Collected data included demographics, history of grade retention, disease severity factors, evidence of stroke, family functioning, and academic achievement. A logistic regression model predicting grade retention was calculated. RESULTS: Increasing age, lower reading achievement, and lower family cohesion were predictive of higher likelihood of grade retention. Also, high family achievement-orientation moderated the negative effects of increasing age on likelihood of grade retention, such that at increasing levels of family achievement-orientation, the relationship between age and grade retention decreased. CONCLUSIONS: These findings suggest the need for interventions that promote connectedness and achievement-orientation in families of youth with SCD. Research is also needed to further explore other possible risk or resilience factors for grade retention in this population, such as school absenteeism.