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Obstructive Sleep Apnoea

Treatment Options - Pharmacologic

There is a lack of evidence for effectiveness of pharmacological treatments.

No pharmacologic therapy has proven to be significantly effective to warrant replacement of non-pharmacologic therapy (See Treatment options).1, 2 Pharmacologic agents of interest included those that might act to stimulate respiratory drive directly (e.g. theophylline – PBS indicated for obstructive airway diseases) or indirectly (e.g. acetazolamide – PBS indicated for glaucoma) 3, that reduce upper airway collapsibility (e.g. desipramine – indicated for depression) 4, antimuscarinics (e.g. oxybutynin – PBS restricted for detrusor overactivity), or noradrenergic agents (e.g. atomoxetine - PBS restricted for attention deficit hyperactivity disorder) - these agents are currently under research investigation, and not currently recommended for routine clinical use.5

Pharmacologic therapy (with wake-promoting agents such as modafinil or armodafinil) may be beneficial as adjunctive therapy of non-pharmacologic treatment options for excessive daytime sleepiness that persists despite documentation of adequate and successful adherence with non-pharmacologic therapy and exclusion of alternative causes of daytime sleepiness.6, 7


AHI - Apnoea-Hypopnoea Index
BBTi - Brief Behavioural Therapy for Insomnia
BMI - Body Mass Index (kg/m2)
BQ - Berlin Questionnaire
CBTi - Cognitive Behavioural Therapy for Insomnia
CELL - Coblation Endoscopic Lingual Lightening
COPD - Chronic Obstructive Pulmonary Disease
CVA - Cerebrovascular Accident
CPAP - Continuous Positive Airway Pressure
CSA - Central Sleep Apnoea
DASS - Depression Anxiety Stress Scale
DBAS - Dysfunctional Beliefs and Attitudes about Sleep
DBP - Diastolic Blood Pressure
DIMS - Difficulties Initiating and/or Maintaining Sleep
DISE - Drug-Induced Sleep Endoscopy
DISS - Daytime Insomnia Symptom Scale
ENT - Ear Nose and Throat
ESS - Epworth Sleepiness Scale
FOSQ - Functional Outcomes of Sleep Questionnaire
FSH - Follicle-Stimulating Hormone
FTP - Friedman Tong Position
GP - General Practitioner
HANDI - RACGP Handbook of Non-Drug Interventions
HGNS - Hypoglossal Herve Htimulation
ISI - Insomnia Severity Index
K10 - Kessler Psychological Distress Scale
MAD - Mandibular Advancement Device
MAS - Mandibular Advancement Rplint
MBS - Medicare Benefits Schedule
MMA - Maxillomandibular Advancement Surgery
MRA - Mandibular Repositioning Appliance
ODI - Oxygenation Desaturation Index
OSA - Obstructive Sleep Apnoea
PLMD - Periodic Limb Movement Disorder
PT - Positional Therapy
PTSD - Post-Traumatic Stress Disorder
PSG - Polysomnography
QSQ - Quebec Sleep Questionnaire
REM - Rapid Eye Movement
RFTB - Radiofrequency Thermotherapy of the Tongue Base
SBP - Systolic Blood Pressure
SCI - Sleep Condition Indicator
SE - Sleep Efficiency
SF36 - Short-Form (36) Health Survey
SMILE - Submucosal Minimally Invasive Lingual Excision
SNRIs - Serotonin-Norepinephrine Reuptake Inhibitors
SOL - Sleep Onset Latency
SSRI - Selective Serotonin Reuptake Inhibitors
TFTs - Thyroid Function Tests
TIB - Time In Bed
TORS - Transoral Robotic Surgery
TST - Total Sleep Time
UPPP - Uvulopalatopharyngoplasty
WASO - Wake After Sleep Onset

Quick links


  1. Mason M, et al. Drug therapy for obstructive sleep apnoea in adults. Cochrane Database Syst Rev 2013;CD003002
  2. Randerath WJ, et al. Non-CPAP therapies in obstructive sleep apnoea. Eur Respir J 2011;37:1000
  3. Eskandari D, et al. Acetazolamide Reduces Blood Pressure and Sleep-Disordered Breathing in Patients With Hypertension and Obstructive Sleep Apnea: A Randomized Controlled Trial. J Clin Sleep Med 2018;14:309
  4. Taranto-Montemurro L, et al. Desipramine improves upper airway collapsibility and reduces OSA severity in patients with minimal muscle compensation. Eur Respir J 2016;48:1340
  5. Taranto-Montemurro L, et al. The Combination of Atomoxetine and Oxybutynin Greatly Reduces Obstructive Sleep Apnea Severity. A Randomized, Placebo-controlled, Double-Blind Crossover Trial. Am J Respir Crit Care Med 2019;199:1267
  6. Chapman JL, et al. Modafinil/armodafinil in obstructive sleep apnoea: a systematic review and meta-analysis. Eur Respir J 2016; 47:1420
  7. Sukhal S, et al. Effect of Wakefulness-Promoting Agents on Sleepiness in Patients with Sleep Apnea Treated with CPAP: A Meta-Analysis. J Clin Sleep Med 2015; 11:1179