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药物治疗阻塞性睡眠呼吸暂停:专家指南

Tackling obstructive sleep apnea with pharmacotherapeutics: expert guidance.

作者信息

Harding Christian D, Fuentes Ana Lucia, Malhotra Atul

机构信息

Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, University of California San Diego (UCSD), La Jolla, CA, USA.

Pulmonary and Critical Care Section, Veterans Affairs San Diego Healthcare System, La Jolla, CA, USA.

出版信息

Expert Opin Pharmacother. 2024 Jun;25(8):1019-1026. doi: 10.1080/14656566.2024.2365329. Epub 2024 Jun 24.

DOI:10.1080/14656566.2024.2365329
PMID:38913403
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11227253/
Abstract

INTRODUCTION

The efficacy of non-pharmacotherapeutic treatment of obstructive sleep apnea, a highly prevalent condition with serious cardiometabolic and neurocognitive health consequences, is well established. Supplementing traditional treatment strategies with medications can improve symptoms and reduce side effects. Efforts to identify medications that target the causes of sleep apnea have met with mixed success. However, this remains a worthwhile objective for researchers to pursue, given the potential benefit pharmacotherapy could bring to those patients who reject or struggle to adhere to existing treatments.

AREAS COVERED

This article presents the case for obstructive sleep apnea pharmacotherapy including drugs that reduce the occurrence of apnea events, such as weight loss agents, ventilation activators and muscle and nervous system stimulants, drugs that alleviate symptoms, such as wake-promoting agents for excessive daytime sleepiness, and drugs that improve adherence to existing treatments, such as hypnotics. Literature was accessed from PubMed between 1 March 2024 and 18 April 2024.

EXPERT OPINION

Exciting recent advances in both our understanding of obstructive sleep apnea pathology and in the techniques used to identify therapeutic agents and their targets combine to embolden a positive outlook for the expanded use of drugs in tackling this consequential disease.

摘要

引言

阻塞性睡眠呼吸暂停是一种高度普遍的疾病,会对心脏代谢和神经认知健康造成严重后果,非药物治疗阻塞性睡眠呼吸暂停的疗效已得到充分证实。在传统治疗策略中添加药物可以改善症状并减少副作用。识别针对睡眠呼吸暂停病因的药物的努力取得了喜忧参半的成果。然而,鉴于药物治疗可能给那些拒绝或难以坚持现有治疗的患者带来潜在益处,这仍然是研究人员值得追求的目标。

涵盖领域

本文阐述了阻塞性睡眠呼吸暂停药物治疗的情况,包括减少呼吸暂停事件发生的药物,如减肥药物、通气激活剂以及肌肉和神经系统兴奋剂;缓解症状的药物,如用于治疗白天过度嗜睡的促醒药物;以及提高对现有治疗依从性的药物,如催眠药。文献检索范围为2024年3月1日至2024年4月18日期间的PubMed数据库。

专家观点

最近在我们对阻塞性睡眠呼吸暂停病理学的理解以及用于识别治疗药物及其靶点的技术方面取得的令人兴奋的进展,共同为扩大药物在治疗这种严重疾病中的应用带来了积极的前景。