title: Hydroxyurea treatment effect on children with sickle cell disease and obstructive sleep apnea.
abstract: BACKGROUND
  While hydroxyurea is the mainstay of treatment for many of the comorbidities associated with sickle cell disease, its effect on obstructive sleep apnea has not been fully investigated. The purpose of this project is to help characterize the effects of hydroxyurea on obstructive sleep apnea in children with sickle cell disease and determine its therapeutic role in the condition.
  
  
  METHODS
  Chart review was conducted on two pediatric patients with sickle cell disease who experienced resolution of obstructive sleep apnea following hydroxyurea administration.
  
  
  RESULTS
  After undergoing approximately 11 months of hydroxyurea therapy, sleep apnea symptoms improved and obstructive sleep apnea resolution was confirmed by repeat polysomnography in both cases. This resolution was largely secondary to a reduction in the obstructive component of the apnea hypopnea index, highlighting a previously unreported association.
  
  
  CONCLUSIONS
  As adenotonsillectomy is associated with significant risks in patients with sickle cell disease, it appears reasonable to consider a period of observation for improvement of obstructive sleep apnea following hydroxyurea administration rather than directly proceeding with surgery.
authors.affiliation: Department of Otolaryngology, Head and Neck Surgery, University of Tennessee Health Science Center, 910 Madison Avenue, Suite 420, Memphis, TN, 38163, USA. agrady2@uthsc.edu.
authors.forename: Anthony J
authors.initials: AJ
authors.lastname: Grady
authors.affiliation: Department of Hematology, St. Jude Children's Research Hospital, 262 Danny Thomas place, Memphis, TN, 38105, USA.
authors.forename: Jane S
authors.initials: JS
authors.lastname: Hankins
authors.affiliation: Department of Pediatric Pulmonology, University of Tennessee Health Science Center, 50 N. Dunlap, 534R W Patient Tower, LBCMC, Memphis, TN, 38103, USA.
authors.forename: Brent
authors.initials: B
authors.lastname: Haberman
authors.affiliation: Department of Pediatric Pulmonology, University of Tennessee Health Science Center, 50 N. Dunlap, 534R W Patient Tower, LBCMC, Memphis, TN, 38103, USA.
authors.forename: Robert
authors.initials: R
authors.lastname: Schoumacher
authors.affiliation: Department of Otolaryngology, Head and Neck Surgery, University of Tennessee Health Science Center, 910 Madison Avenue, Suite 420, Memphis, TN, 38163, USA.
authors.forename: Rose Mary
authors.initials: RM
authors.lastname: Stocks
mesh_terms: D000233:Adenoidectomy / Q000009:adverse effects; D000755:Anemia, Sickle Cell / Q000150:complications*; D002648:Child; D002675:Child, Preschool; D006801:Humans; D006918:Hydroxyurea / Q000627:therapeutic use*; D008297:Male; D017286:Polysomnography; D020181:Sleep Apnea, Obstructive / Q000150:complications* / Q000601:surgery / Q000628:therapy*; D014068:Tonsillectomy / Q000009:adverse effects
chemical_list: D006918:Hydroxyurea
keywords: Adenotonsillectomy; Hydroxyurea; Obstructive sleep apnea; Pediatric; Polysomnography; Sickle cell disease