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Obstructive Sleep Apnea: Emerging Treatments Targeting the Genioglossus Muscle

1
Sleep Unit, Pneumology Department, Hospital Universitario de Guadalajara, 19005 Guadalajara, Spain
2
Medicine Department, Universidad de Alcalá, Alcalá de Henares, 28871 Madrid, Spain
3
Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), 28029 Madrid, Spain
4
Pneumology Department, Hospital Universitario Ramón y Cajal, 28034 Madrid, Spain
5
Group of Translational Research in Respiratory Medicine, Hospital Universitari Arnau de Vilanova-Santa Maria, IRBLleida, 25198 Lleida, Spain
6
Psychiatric Department. Hospital General La Mancha Centro, 13600 Toledo, Spain
7
Radiology Department, Hospital Universitario de Guadalajara, 19005 Guadalajara, Spain
8
Pneumology Department, Hospital Universitario La Paz, IdiPAZ, 28046 Madrid, Spain
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2019, 8(10), 1754; https://doi.org/10.3390/jcm8101754
Received: 16 September 2019 / Revised: 11 October 2019 / Accepted: 18 October 2019 / Published: 22 October 2019
Obstructive sleep apnea (OSA) is characterized by repetitive episodes of upper airway obstruction caused by a loss of upper airway dilator muscle tone during sleep and an inadequate compensatory response by these muscles in the context of an anatomically compromised airway. The genioglossus (GG) is the main upper airway dilator muscle. Currently, continuous positive airway pressure is the first-line treatment for OSA. Nevertheless, problems related to poor adherence have been described in some groups of patients. In recent years, new OSA treatment strategies have been developed to improve GG function. (A) Hypoglossal nerve electrical stimulation leads to significant improvements in objective (apnea-hypopnea index, or AHI) and subjective measurements of OSA severity, but its invasive nature limits its application. (B) A recently introduced combination of drugs administered orally before bedtime reduces AHI and improves the responsiveness of the GG. (C) Finally, myofunctional therapy also decreases AHI, and it might be considered in combination with other treatments. Our objective is to review these therapies in order to advance current understanding of the prospects for alternative OSA treatments. View Full-Text
Keywords: Genioglossus muscle; sleep apnea; pharmacological treatment; hypoglossal nerve electrical stimulation; myofunctional therapy Genioglossus muscle; sleep apnea; pharmacological treatment; hypoglossal nerve electrical stimulation; myofunctional therapy
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Mediano, O.; Romero-Peralta, S.; Resano, P.; Cano-Pumarega, I.; Sánchez-de-la-Torre, M.; Castillo-García, M.; Martínez-Sánchez, A.B.; Ortigado, A.; García-Río, F. Obstructive Sleep Apnea: Emerging Treatments Targeting the Genioglossus Muscle. J. Clin. Med. 2019, 8, 1754.

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