> the ampakines can avoid the oxygen drop by increasing the tonic stimulation of the basal breathing centers, the arousal mechanism that would trigger awakening, would never come into play<
Sorry I was not clear. My intended meaning was: if the ampakine upregulated the basal (pre-Botzinger complex) breathing centers ENOUGH, then the arousal would not occur or be needed to maintain adequate oxygenation.
You are quite correct, MarketFest4, there are many different cause of sleep apnea. Most classifications divide them arbitrarily into mechanical and central (neurologic) causes. The reality is that most fall into the combination of the two. Just to make the point, an individual could experience an obstructive pattern trying to sleep on their back, but then still experience central pattern while on their side.
The ampakines would theoretically be more effective in central causes. They would still tend to exert a favorable effect (through the same pre-Botzinger complex) in the obstructive pattern by enhancing respiratory muscles and accessory muscles sufficiently to reduce the frequency and severity of the periods of apnea, so that symptoms could improve. With enough stimulation this could happen without arousing the patient from restorative sleep. More likely, adjunctive therapy would also be needed.
Clearly the causes of sleep apnea are as complex and diverse as the causes of dementia or as the causes of vascular disease. No one treatment will suffice and all identifiable risk factors need to be considered for therapy or favorable modification.
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