Hydroxyurea Therapy and Sleep-Disordered Breathing in Children With Sickle Cell Disease

Bidirectional relationships exist among sickle cell disease (SCD), sleep-disordered breathing (SDB), and hydroxyurea therapy, and this complex interplay poses challenges to research attempting to elucidate causal mechanisms and determine therapeutic targets. We therefore set out to study all three components of this clinical triad simultaneously (SCD, SDB, and hydroxyurea therapy), documenting correlations and suggesting underlying pathophysiological mechanisms. Hydroxyurea therapy was associated with improved SDB and with decreased inflammation, implicating the anti-inflammation effects of hydroxyurea as a plausible mechanism driving these correlations. These results underscore the need for longitudinal studies to elucidate causal relationships.