[Can drug therapy for obstructive sleep apnea be expected after all?]

Abstract

Obstructive sleep apnea (OSA) is a very common sleep disorder and is usually a chronic disease. Indications for treatment depend on the severity of the nocturnal breathing disorder; the specific symptoms, such as daytime sleepiness; and the comorbidities, which, together with the breathing disorder, constitute the risk of sleep apnea. Standard treatment is nocturnal positive airway pressure therapy or, especially for mild to moderate sleep apnea, a mandibular advancement device. Surgical measures are only carried out if indicated. A specific and effective sleep apnea medication does not yet exist. The first approved medication for obese OSA sufferers is tirzepatide, which leads to a reduction in nocturnal breathing disorders through effective weight reduction. Alternative and in some cases more specific medications are currently being researched. These include, for example, carbonic anhydrase inhibitors, anticholinergics, serotonin-noradrenaline reuptake inhibitors, sympathomimetics, and cannabinoids. Drug therapy for sleep apnea will enrich an individualized therapy in the future that is geared toward the phenotype of sleep apnea.