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Sleep apnea, CENTRAL, OBSTRUCTIVA, Verónica Jinued Barba Arriaga LME8396 …

- - - - Uvulopalatopharyngoplasty
        One of the surgical techniques considered a good alternative to CPAP consists of resection of the uvula, soft palate, and posterior pillars, that is, uvulopalatopharyngoplasty, which increases the diameter of the oropharynx.
      - Oral prostheses
        They are orthodontic techniques using appliances that manage to prevent the tongue from falling or keep the jaw in a more forward position to prevent the collapse of the upper airway during sleep.
  - - - Opioid antagonists
        Due to the possible existence of an increase in the concentration of opioids in the cerebrospinal fluid of patients with OSAS, opioid antagonists or brain stimulants have been proposed as an option in the treatment of this pathology. Thus, studies with doxapram show a decrease in the duration of apneas, while the results with naloxone are scarce.
      - Medroxyprogesterone
        This hormonal treatment acts as a respiratory stimulus at a dose of 60 mg/day, but it must be taken into account that this same dosage produces significant feminizing effects.
      - Benzodiazepines
        Although clonazepam has been shown to reduce the number of obstructive apneas in some cases of OSAS, the use of this type of pharmacological agent is risky due to its possible action of ventilatory depression.
      - Nicotine
        Nicotine acts by stimulating the muscles of the upper airway, thus being able to decrease the resistance of this pathway.
      - Acetazolamide
        A dose of 250 mg has shown some improvement in patients with OSAS through its action as a ventilatory stimulant.
      - Psychotropic drugs
        Antidepressant agents have been used in the treatment of OSAS due to their ability to reduce REM sleep, the phase in which apneas are more important and frequent.
      - Theophylline
        It has been shown that this ventilatory stimulant significantly reduces the number of apneas-hypopneas as well as their duration.
      - Angiotensin converting enzyme (ACE) inhibitors
        Hypertensive patients treated with ACE inhibitors have shown improvement in their OSAS. The effect of these agents is due to their reducing action on sympathetic tone, which decreases respiratory variability and, consequently, improves OSAS.
      - Others
        OSAS secondary to endocrine diseases such as hypothyroidism or acromegaly can be resolved by pharmacological treatment with thyroxine, somatostatin and bromocriptine, respectively.