Over the past decades, researchers have come up with many approaches to treat obstructive sleep apnea (OSA). Yet, there isn’t a single effective solution to treat the condition. The conventional treatment options include lifestyle changes, breathing devices, mouthpieces, and surgery. Medications aren’t typically recommended for OSA.
Pharmaceutical scientists have been researching for years to find a safe and effective “drug” to treat OSA. But, not a single promising drug has been found as far. A long list of drugs has been tested and used, but no drug can be recommended to prevent the sleep-induced block of the upper airway.
Fluoxetine, medroxyprogesterone, protriptyline, nicotine, naloxone, theophyline, and acetazolamide have been used for the treatment of OSA; however, they are not recommended. Although these drugs don’t provide any significant benefit to an OSA patient, but they tend to stimulate breathing during sleeplessness. The hypothesis behind using these medications is that these might help ease the collapse of the upper airway during sleep by increasing the activity of the dilating muscles.
Fluoxetine, a selective serotonin re-uptake inhibitor, has been considered as an auspicious drug for OSA. It is found to increase the activity of the tongue muscles during sleep. Moreover, in a study, it was reported to show better tolerance than protriptyline among OSA patients. But, fluoxetine has not been found to greatly improve OSA.
OSA often brings a few consequences in patients. Excessive sleepiness is a significant, residual consequence of sleep-disordered breathing. However, the conventional therapies, available to treat OSA, do not always resolve it completely.
Modafinil (Provigil) is recently approved by the FDA for OSA patients who have excessive sleepiness despite optimal use of continuous positive airway pressure (CPAP) therapy. Armodafinil (Nuvigil), a modified form of modafinil, is also another FDA approved wakefulness-promoting agent. However, it needs to be remembered that these two medications are not a treatment for OSA. For OSA patients, they can be only used when excessive daytime sleepiness is associated.
In conclusion, it can be said that as there is not a single drug that can significantly improve OSA, patients should not rely on taking only oral pills. They must consult with a sleep disorder specialist for a better suggestion about using other treatment options.
The American Sleep Apnea Association has suggested lifestyle changes and oral appliances as a long-term treatment option for OSA. Few formal studies have already reported that weight loss can lead an OSA patient to lesser, lighter snoring and diminish occurrences of apnea and hypopnea during sleep. On the other hand, although oral appliances have endorsed by the American Academy of Sleep Medicine, but finding the right device could be a daunting task.