Replies to post #15964 on RespireRx Pharmaceuticals Inc (RSPI)

[atheroprevent]

Thanks myostrain, well stated.

I agree, enemem, pure central sleep apnea is not common and more likely seen in post stroke and chronic heart failure. The benefit in upregulating respiratory tonic pathways. however, must impact the spectrum of obstructive sleep apnea.

I understand Medicare is looking at approving home sleep apnea testing. This would potentially reduce the barrier to diagnosis and would shift treatment to a larger group of primary care physicians and drive the market potential of ampakines for sleep apnea.

Just an anecdotal case........ last night one of my partners was called in to transfer a patient to the intensive care unit. The patient had abdominal surgery and after 4 hours of observation in the recovery room the patient was "still breathing slowly". Narcan was obviously not a treatment option after surgery. An ampakine for RD would have probably reduced cost and length of hospital stay and would have restored at least 2 hours of quality sleep that my partner lost.

[enemem]

Obstructive sleep apnea is a common disorder characterized by repetitive collapse of the pharyngeal airway during sleep. The disorder results primarily from an anatomically small upper airway in conjunction with pharyngeal dilator muscles that can compensate for the anatomic deficiency awake, but not asleep . Ventilatory control instability and a low arousal threshold may contribute to the disorder as well. The consequences of sleep apnea fall into two domains: (1) neurocognitive dysfunction (sleepiness and decreased quality of life) resulting from sleep fragmentation and (2) cardiovascular disease (hypertension, stroke, myocardial infarction, and heart failure) likely resulting from the intermittent hypoxia. The disorder is generally diagnosed in the sleep laboratory over the course of a night, although alternative approaches in the home are also utilized. A number of treatment options are available. Continuous positive airway pressure remains the most consistently effective approach, although oral appliances (generally mandibular-advancing devices) and a number of surgical procedures have some demonstrated efficacy. Thus, therapy must be individualized to the patient's desires and the severity of the apnea.



White DP. Sleep apnea Proc Am Thorac Soc. 2006;3(1):124-8.

I've unsuccessfully attempted to upload a figure from that paper, showing the airways of an obese and normal-weight subject. It's a nice review.