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Emerging Therapies for Obstructive Sleep Apnea

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Abstract

Obstructive sleep apnea (OSA) is a prevalent disorder often associated with daytime sleepiness, cognitive dysfunction, and adverse cardiovascular consequences. Available therapies are limited by either lack of long-term adherence or low response rates. Two emerging therapies hold promise in providing alternatives to patients with OSA. The first stems from the importance of the upper-airway dilator muscles in maintaining pharyngeal stability. Electrical stimulation of the genioglossus muscle improves both upper-airway diameter and ameliorates pharyngeal obstruction. The results of phase I and II clinical trials hold promise, but the reported improvements in the apnea–hypopnea index vary between subjects and concerns about long-term safety await long-term studies. The second technology relies on creating an increased expiratory nasal resistance via a bidirectional valve designed to be worn just inside the nostrils. Initial findings of clinical trials suggest reduction in severity of sleep apnea and subjective daytime sleepiness. Considerable heterogeneity in response to the nasal device was noted despite the high adherence rates. It remains unclear which patients will likely benefit a priori from these devices.

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Acknowledgment

This work was supported in part by VA Merit Review Award HSR&D 10-087-1 (AES). The opinions of the authors herein are the private views of the authors and are not to be construed as reflecting the views of the Department of Veterans Affairs.

Conflict of interest

The authors have no conflicts of interest to disclose.

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Authors and Affiliations

  1. The Veterans Affairs Western New York Healthcare System, Buffalo, NY, USA

    Morohunfolu Akinnusi, Ranime Saliba & Ali A. El-Solh

  2. Western New York Respiratory Research Center, Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, State University of New York at Buffalo School of Medicine and Biomedical Sciences and School of Public Health and Health Professions, Buffalo, NY, USA

    Morohunfolu Akinnusi, Ranime Saliba & Ali A. El-Solh

  3. Department of Social and Preventive Medicine, State University of New York at Buffalo School of Medicine and Biomedical Sciences and School of Public Health and Health Professions, Buffalo, NY, USA

    Morohunfolu Akinnusi, Ranime Saliba & Ali A. El-Solh

  4. Medical Research, Bldg. 20 (151) VISN02, VA Western New York Healthcare System, 3495 Bailey Avenue, Buffalo, NY, 14215-1199, USA

    Ali A. El-Solh

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  1. Morohunfolu Akinnusi
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Correspondence to Ali A. El-Solh.

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Akinnusi, M., Saliba, R. & El-Solh, A.A. Emerging Therapies for Obstructive Sleep Apnea. Lung 190, 365–371 (2012). https://doi.org/10.1007/s00408-012-9380-1

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