Fietze Ingo
Interdisziplinäres Schlafmedizinisches Zentrum, Charité - Universitätsmedizin Berlin, Luisenstr. 13, 10117, Berlin, Deutschland.
Inn Med (Heidelb). 2025 May 12. doi: 10.1007/s00108-025-01902-8.
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.
阻塞性睡眠呼吸暂停(OSA)是一种非常常见的睡眠障碍,通常是一种慢性疾病。治疗指征取决于夜间呼吸障碍的严重程度、特定症状(如白天嗜睡)以及合并症,这些合并症与呼吸障碍共同构成睡眠呼吸暂停的风险。标准治疗方法是夜间持续气道正压通气治疗,或者对于轻度至中度睡眠呼吸暂停,使用下颌前移装置。仅在有指征时才进行手术治疗。目前尚无特效的睡眠呼吸暂停药物。首个获批用于肥胖OSA患者的药物是替尔泊肽,它通过有效减轻体重来减少夜间呼吸障碍。目前正在研究其他药物,在某些情况下这些药物更具特异性。例如,包括碳酸酐酶抑制剂、抗胆碱能药物、5-羟色胺-去甲肾上腺素再摄取抑制剂、拟交感神经药和大麻素。睡眠呼吸暂停的药物治疗未来将丰富针对睡眠呼吸暂停表型的个体化治疗。