A neurotoxinological approach to the treatment of obstructive sleep apnoea

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Sleep Med Rev. 2007 Jul 21

A neurotoxinological approach to the treatment of obstructive sleep

apnoea.

Conduit R, Sasse A, Hodgson W, Trinder J, Veasey S, Tucker A.

School of Psychology, Psychiatry & Psychological Medicine, Faculty

of Medicine, Nursing & Health Sciences, Monash University, 900

Dandenong Road Caulfield, Melbourne, Vic. 3145, Australia.

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.