Revisiting the Role of Serotonin in Sleep-Disordered Breathing

Area of Science:

• Neuroscience
• Respiratory Physiology
• Sleep Medicine

Background:

• Serotonin (5-hydroxytryptamine, 5-HT) is a key neurotransmitter regulating central nervous system functions, including breathing control and sleep-wake states.
• Obesity is a significant risk factor for sleep-disordered breathing (SDB), encompassing obstructive sleep apnea (OSA) and obesity hypoventilation syndrome (OHS).
• Millions worldwide suffer from OSA and OHS, conditions linked to impaired respiratory regulation.

Purpose of the Study:

• To review the critical role of serotonin (5-HT) in the pathophysiology of sleep-disordered breathing (SDB).
• To discuss the mechanisms by which 5-HT modulates neural control of breathing and upper airway patency.
• To highlight current and emerging therapeutic strategies targeting the 5-HT system for SDB treatment.

Main Methods:

• Literature review of studies investigating serotonin's role in respiratory control and SDB.
• Analysis of research on 5-HT receptor subtypes and their impact on breathing and airway function.
• Synthesis of findings on the efficacy of 5-HT-targeted interventions for OSA and OHS.

Main Results:

• Serotonergic nuclei in the brainstem are crucial for maintaining hypercapnic ventilatory response and upper airway stability.
• Dysregulation of 5-HT signaling contributes to the development and severity of SDB in obese individuals.
• Specific 5-HT receptor pathways are implicated in modulating arousal and respiratory drive during sleep.

Conclusions:

• Serotonin plays a vital role in preventing upper airway collapse and ensuring adequate ventilation during sleep.
• Targeting 5-HT pathways offers a promising therapeutic avenue for managing SDB, particularly in obesity.
• Further research into 5-HT receptor modulation could lead to novel treatments for OSA and OHS.