New frontiers in pharmacologic obstructive sleep apnea treatment: A narrative review

Schütz, Sonja G.; Dunn, Arlo M.; Braley, Tiffany J.; Pitt, Bertram; Shelgikar, Anita Valanju

doi:10.1016/j.smrv.2021.101473

Cited by 26 publications

(20 citation statements)

References 87 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…133 However, some studies failed to show a consistent benefit with CPAP on blood pressure. 129,134, 135 The conflicting results may represent different control instability, 150 and benzodiazepines have been used to target a low arousal threshold. 151 Finally, there are studies ongoing into using transcutaneous electrical stimulation to increase neuromuscular tone of the upper airway dilator muscles of patients with OSA during sleep.…”

Section: Mechanisms Of Cardiovascular Disease In Obstructivementioning

confidence: 99%

Cardiovascular manifestations in obstructive sleep apnea: current evidence and potential mechanisms

O’Donnell¹,

O'Mahony²,

McNicholas³

et al. 2021

Polish Archives of Internal Medicine

View full text Add to dashboard Cite

as nonrestorative sleep and excessive daytime sleepiness (EDS). 7,8In addition to EDS, OSA is associated with reduced quality of life, poor cognitive function, and road traffic accidents, independent of age or sex. 9 -11 The principal morbidity and mortality of the condition, however, are due to the increased risk of the development and progression of numerous CVDs. 4 A large body of evidence has accumulated to date strengthening the association between OSA and CVD, with increased risk persisting after correction for common cardiovascular risk factors. 12 Obstructive sleep apnea is associated with increased incidence of systemic arterial hypertension, coronary artery disease, congestive cardiac failure, and stroke, 4,13,14 and although Introduction Obstructive sleep apnea (OSA) is a growing public health problem. 1 The prevalence of the disorder has been increasing rapidly over the last 2 decades in line with the obesity epidemic in the developed world. 2-4 It is estimated that OSA affects nearly 1 billion people worldwide. However, a significant proportion of patients remain undiagnosed, 5 with one estimate suggesting that more than 30 million people are undiagnosed in Europe alone. 1 There is a male to female predominance of 2 to 1, and OSA is more common in the middle -aged and elderly population. 6 Obstructive sleep apnea is characterized by recurrent partial or complete upper airway collapse during sleep leading to intermittent hypoxia (IH) and recurrent arousals culminating in disrupted sleep quality that typically manifests

show abstract

Section: Mechanisms Of Cardiovascular Disease In Obstructivementioning

confidence: 99%

Cardiovascular manifestations in obstructive sleep apnea: current evidence and potential mechanisms

O’Donnell¹,

O'Mahony²,

McNicholas³

et al. 2021

Polish Archives of Internal Medicine

View full text Add to dashboard Cite

show abstract

“…A stated before, different mechanisms can contribute to multifactorial OSA pathophysiology [5], including: increased collapsibility of the passive upper airway; impaired neuromuscular tone (relative hypotonia of upper airway dilator muscle/genioglossus muscle) and sympathetic neural activity; greater the loop gain; anatomic craniofacial features (increased anterior facial height, decreased pharyngeal airspace, inferiorly placed hyoid bone); high body mass index (obesity); rostral fluid shifts. This heterogenous pathogenesis can generate opportunities for therapies with diverse mechanisms of action: antihypertensive medication (acetazolamide; spironolactone), anti-inflammatory agents, antidiabetic medications, antidepressant medications or synthetic cannabinoids [5]. Moreover, Lavigne, in 2009 [3], stated that "of all the metabolic syndrome components, OSA has been most strongly linked with hypertension".…”

Section: Pharmacotherapy Agents and Osa Pathophysiologymentioning

confidence: 99%

“…However, the sleep-quality becomes poor, physiological sleep-pattern is disturbed and the individuals are constantly tired during the day, their work performance is affected and their quality of life decreases; moreover, individuals can even cause various work, road or domestic accidents due to excessive day-time sleepiness. OSA is a potentially life-threatening disease, its consequences including high blood pressure, diabetes, heart attack or stroke [3][4][5].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Elements of Diagnosis and Non-surgical Treatment of Obstructive Sleep Apnea in Adults from the Dental Medicine Perspective

Trăistaru¹,

Pantea²,

Țâncu³

et al. 2022

Sleep Medicine and the Evolution of Contemporary Sleep Pharmacotherapy

View full text Add to dashboard Cite

Dentists hold a key role in the context of ever-growing concerns regarding the management of Obstructive Sleep Apnea (OSA) in adults. Dentists’ contribution in this domain starts with the screening of patients with possible OSA. An earlier intervention for correcting a dento-maxillary anomaly or a parafunction will often serve as a preventive treatment with regard to possible OSA. Furthermore, dental medicine offers nowadays, apart from orthodontic and surgical treatment, a set of therapeutical methods, the most commonly used being the oral appliance and myofunctional therapies. Another important sphere of professional responsibility of the dentist involved in the treatment of OSA consists of periodical examinations focused on assessing clinical evolution, corrective interventions on oral appliances and interventions for preventing local complications. On the other hand, recent studies indicate the potential of different pharmacotherapy agents on OSA pathophysiology, severity and treatment. These agents have shown promising results in improving the efficacy of other therapies dedicated to OSA, therefore, current topics in modern scientific research include the evaluation of standard, even higher doses of single agents or the combination of different agents on the evolution of OSA, as well as the assessment of the association of diverse pharmacotherapy agents with other OSA therapies.

show abstract

“…It is now increasingly appreciated that OSA is heterogenous disease, with different phenotypes and endotypes, reflecting different pathogenetic mechanisms for sleep‐disordered breathing and its downstream sequelae 1 . This has fuelled research in the use of treatment modalities for OSA other than CPAP therapy, 2 and this study on the effect of adding zolpidem to the combination of atomoxetine‐oxybutynin in a recent publication in Respirology 3 is a welcome addition to the topic.…”

mentioning

confidence: 99%

Pharmacotherapy for obstructive sleep apnoea: Is the magic bullet in sight?

Chung

2021

Respirology

View full text Add to dashboard Cite

show abstract

New frontiers in pharmacologic obstructive sleep apnea treatment: A narrative review

Cited by 26 publications

References 87 publications

Cardiovascular manifestations in obstructive sleep apnea: current evidence and potential mechanisms

Cardiovascular manifestations in obstructive sleep apnea: current evidence and potential mechanisms

Elements of Diagnosis and Non-surgical Treatment of Obstructive Sleep Apnea in Adults from the Dental Medicine Perspective

Pharmacotherapy for obstructive sleep apnoea: Is the magic bullet in sight?

Contact Info

Product

Resources

About