Pharmacotherapy of obstructive sleep apnea. Is salvation just around a corner.pdf
Thomaz Fleury Curado
10.25376/hra.7800515.v1
https://hra.figshare.com/articles/journal_contribution/Pharmacotherapy_of_obstructive_sleep_apnea_Is_salvation_just_around_a_corner_pdf/7800515
Obstructive sleep apnea (OSA) is recurrent upper airway obstruction caused by a loss
of upper airway muscle tone during sleep, which leads to intermittent hypoxia and
sleep fragmentation1
. OSA is a common disorder affecting 25-30% of adult population
and more than 50% of obese individuals 2
. Continuous positive airway pressure
(CPAP) relieves OSA, but poor adherence severely limits its use 3
. Mandibular
advancement devices have better compliance, but not as effective as CPAP 4
. There
is no effective pharmacotherapy.
Successful drug development is possible only when the pathogenesis of the disease
is fully understood. Four key pathophysiological mechanisms of OSA have been
identified: (1) anatomically compromised or collapsible upper airway; (2) inadequate
compensatory responses of the upper airway dilator muscles during sleep; (3) a low
arousal threshold, (4) an overly sensitive ventilatory control drive 5
. Anatomic
predisposition plays a primary role in OSA pathogenesis 6
, whereas faulty
neuromuscular mechanisms during sleep fail to compensate adequately for
compromised pharyngeal patency 7
.
2019-03-04 20:01:43
Obstructive Sleep Apnea Syndrome
Pharmacology