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Updated: Jul 17, 2025

Drug-Induced Sleep Endoscopy DISE with Target Controlled Infusion TCI and Bispectral Analysis in Obstructive Sleep Apnea

Drug-Induced Sleep Endoscopy DISE with Target Controlled Infusion TCI and Bispectral Analysis in Obstructive Sleep Apnea

Published on: December 6, 2016

Pharmacotherapy for obstructive sleep apnea: targeting specific pathophysiological traits.

Elisa Perger¹, Simona Bertoli^1,2,3, Carolina Lombardi^1,4

¹Sleep Disorders Center & Department of Cardiovascular, Neural and Metabolic Sciences, Istituto Auxologico Italiano, IRCCS, Milan, Italy.

Expert Review of Respiratory Medicine

|August 30, 2023

Summary

New pharmacological treatments targeting obstructive sleep apnea (OSA) pathophysiology offer hope. Understanding individual patient traits will enable precision medicine approaches for better sleep disordered breathing management.

Keywords:

CPAP OSA endotypes OSA pharmacotherapy OSA phenotypes Precision medicine atomoxetine sleep disordered breathing

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Area of Science:

Sleep Medicine
Pharmacology
Respiratory Physiology

Background:

Obstructive sleep apnea (OSA) pathophysiology is complex and multifactorial.
Identified traits include pharyngeal collapsibility, upper airway muscle reactivity, arousal threshold, and ventilatory drive regulation.
Current treatments like CPAP have limitations, necessitating novel therapeutic strategies.

Purpose of the Study:

To explore novel pharmacological treatments for OSA targeting specific pathophysiological endotypes.
To review existing and emerging drugs impacting OSA mechanisms.
To summarize promising pharmacotherapies based on their action on key OSA traits.

Main Methods:

Literature review of pharmacological agents and their impact on OSA pathophysiology.
Analysis of drug mechanisms related to upper airway collapsibility, muscle responsiveness, arousal threshold, and loop gain.
Synthesis of evidence for targeted OSA treatment approaches.

Main Results:

Several pharmacological drugs show potential by influencing specific OSA endotypes.
Drugs can modulate pharyngeal collapsibility, muscle activity, arousal thresholds, and ventilatory control.
Combinations of therapies may offer diverse treatment options beyond conventional methods.

Conclusions:

Understanding individual OSA pathophysiology is crucial for effective intervention.
Pharmacological advancements pave the way for precision medicine in OSA treatment.
Future sleep specialists may tailor treatments based on patient-specific disease mechanisms.