Pharmacotherapy of obstructive sleep apnea. Is salvation just around a corner.pdf (81.71 kB)
Download filePharmacotherapy of obstructive sleep apnea. Is salvation just around a corner.pdf
journal contribution
posted on 2019-03-04, 20:01 authored by Thomaz Fleury CuradoObstructive 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
.