Behavioral and pharmacologic therapy of obstructive sleep apnea.
Previous attempts at using pharmacologic agents in the treatment of OSA have been disappointing. Medroxyprogesterone has not been found to be useful in the treatment of OSA. Use of protriptyline is limited by frequent side effects, but its role in mild and REM-related OSA must be clarified. SSRIs seem to be ineffective in treatment of severe OSA. Further studies are needed to determine their effect in persons with mild disease. This is important because patients with mild OSA (AHI < 15 hours) are most likely to be noncompliant with CPAP therapy [91]. A recent systematic review of drug treatments for OSA concluded that the current data do not support the use of any drug as an alternative to CPAP [92]. Of 56 studies identified, only 9 studies met methodologic criteria. Clearly, basic research and adequately powered clinical trials are needed to identify an effective medication for OSA.
Magalang
Ulysses J
UJ
Division of Pulmonary, Critical Care, and Sleep Medicine, University at Buffalo, State University of New York, 3435 Main Street, Buffalo, NY 14214, USA. magalang@buffalo.edu
Mador
M Jeffery
MJ
D032763:Behavior Control; D001521:Behavior Therapy; D004358:Drug Therapy; D006801:Humans; D020181:Sleep Apnea, Obstructive / Q000628:therapy*