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dc.contributor.authorJordan, Amy S-
dc.contributor.authorO’Donoghue, Fergal J-
dc.contributor.authorCori, Jennifer M-
dc.contributor.authorTrinder, John-
dc.identifier.citationAmerican Journal of Respiratory and Critical Care Medicine 2017; 196(7): 814-821en_US
dc.description.abstractTreatment options for patients with obstructive sleep apnea (OSA) intolerant of continuous positive airway pressure (CPAP) are limited. Thus, new therapies are sought. Recently, there has been interest in using sedatives to delay arousal from sleep, allowing upper airway dilator muscle recruitment sufficient to re-open the airway while maintaining sleep. In this review the rationale for sedative use and prior sedative studies in OSA are presented, along with a description of six factors that may determine sedative treatment success. It is proposed that in order for a sedative to treat OSA the patient must have each of the following three traits: 1) a mild to moderately collapsible upper airway, 2) responsive and effective upper airway dilator muscles and 3) a low to moderate arousal threshold. In addition (4), proponents of sedative treatment generally believe that to be effective the sedative must increase the arousal threshold. Finally (5), sedatives may have additional utility in patients with large ventilatory responses to arousal and (6) the metric used to define sedative success needs to be considered. To date, few of these factors have been evaluated in sedative trials. Further, it is likely only a relatively small percentage of patients will have all of the required traits. If sedative treatment is successful in appropriate patients, easily measured surrogate markers for the factors that determine sedative success will be critical for implementation in the clinic. Finally, sedatives may have detrimental outcomes for some patients and prospective identification of such patients will be required.en_US
dc.subjectObstructive sleep apneaen_US
dc.subjectPharyngeal collapseen_US
dc.titlePhysiology of arousal in OSA and potential impacts for sedative treatmenten_US
dc.typeJournal Articleen_US
dc.identifier.journaltitleAmerican Journal of Respiratory and Critical Care Medicineen_US
dc.identifier.affiliationInstitute for Breathing and Sleep, Austin Health, Heidelberg, Victoria, Australiaen_US
dc.identifier.affiliationDepartment of Psychology, University of Melbourne, Parkville, Victoria, Australiaen_US
dc.identifier.affiliationMelbourne School of Psychological Sciences, University of Melbourne, Melbourne, Victoria, Australiaen_US
dc.type.austinJournal Articleen_US
item.openairetypeJournal Article-
item.fulltextNo Fulltext-
item.cerifentitytypePublications- and Sleep Medicine- for Breathing and Sleep- for Breathing and Sleep-
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