title: A neurotoxinological approach to the treatment of obstructive sleep apnoea.
abstract: Current treatment approaches to the problem of obstructive sleep apnoea (OSA) have limitations. Specifically, invasive anatomical-based surgery and dental appliances typically do not alleviate obstruction at an acceptable rate, and compliance to continuous positive airway pressure (CPAP) devices is frequently suboptimal. Neurotoxinological treatment approaches are widespread in the field of medicine, but as yet have not been evaluated as a treatment for sleep-disordered breathing. In this review, it is argued that despite widespread recognition of the loss of upper airway (UA) muscular tone and/or reflexes in the expression of OSA, most treatment interventions to date have focused on anatomical principles alone. Several hypothesised neurotoxinological interventions aimed at either enhancing UA neuromuscular tone and/or reflexes are proposed, and some preliminary data is presented. Although in its early infancy, with considerable toxicity studies in animals yet to be done, a neurotoxinological approach to the problem of OSA holds promise as a future treatment, with the potential for both high effectiveness and patient compliance.
authors.affiliation: School of Psychology, Psychiatry & Psychological Medicine, Faculty of Medicine, Nursing & Health Sciences, Monash University, 900 Dandenong Road Caulfield, Melbourne, Vic 3145, Australia. russell.conduit@med.monash.edu.au
authors.forename: Russell
authors.initials: R
authors.lastname: Conduit
authors.forename: Anthony
authors.initials: A
authors.lastname: Sasse
authors.forename: Wayne
authors.initials: W
authors.lastname: Hodgson
authors.forename: John
authors.initials: J
authors.lastname: Trinder
authors.forename: Sigrid
authors.initials: S
authors.lastname: Veasey
authors.forename: Adam
authors.initials: A
authors.lastname: Tucker
mesh_terms: D001496:Batrachotoxins / Q000494:pharmacology / Q000627:therapeutic use; D016503:Drug Delivery Systems; D004341:Drug Evaluation; D006801:Humans; D008387:Marine Toxins / Q000494:pharmacology / Q000627:therapeutic use; D018482:Muscle, Skeletal / Q000187:drug effects* / Q000378:metabolism; D009498:Neurotoxins / Q000494:pharmacology* / Q000627:therapeutic use*; D012107:Research Design; D012604:Scorpion Venoms / Q000494:pharmacology / Q000627:therapeutic use; D012890:Sleep / Q000187:drug effects*; D020181:Sleep Apnea, Obstructive / Q000188:drug therapy* / Q000503:physiopathology; D012910:Snake Venoms / Q000494:pharmacology / Q000627:therapeutic use; D014701:Veratridine / Q000494:pharmacology / Q000627:therapeutic use
chemical_list: D001496:Batrachotoxins; D008387:Marine Toxins; D009498:Neurotoxins; D012604:Scorpion Venoms; D012910:Snake Venoms; D014701:Veratridine