[Future direction of therapies for sleep related breathing disorders]

There are several mechanisms by which pharmacologic agents might improve sleep related breathing disorders. Upper airway muscle atony during sleep and fat deposition on the upper airway walls are critical in the pathogenesis of upper airway obstruction. As central neuromediators that regulate upper airway muscle activity, serotonin, gamma amino-butyric acid and thyrotropin releasing hormone are reviewed. Although agonists or antagonists of these mediators changed the upper airway muscle activity, no agents have successfully improved sleep related breathing disorders. Leptin is a protein produced by adipose tissue that interacts with receptors in the hypothalamus to inhibit eating. Leptin might have therapeutic potential for obesity-related breathing disorders related to a relative deficiency in leptin, or a leptin resistance.