Medroxyprogesterone acetate in the treatment of obstructive sleep apnea

The use of MPA in patients with OSA is limited. Instead, patients with OSA should be encouraged to abstain from alcohol and respiratory depressive agents, and avoid sleeping in the supine position. In general, patients with OSA are most effectively treated with CPAP and/or surgery. Patients need to be encouraged to maintain ideal body weight, since this has been associated with a marked reduction in symptoms. For patients who are not surgical candidates or refuse to use CPAP, drug therapy may be beneficial. Fluoxetine has been shown to be as effective as protriptyline, and is better tolerated. However, further study is needed to determine whether selective serotonin-reuptake inhibitors are beneficial in treating OSA. Therefore, MPA therapy should be reserved for hypercapnic patients who refuse other modalities of treatment. The potential long-term adverse effects of MPA must be addressed before initiating therapy in men with OSA.