Introduction: Obstructive sleep apnea syndrome is a common public health problem in the general population. The important health-related consequences of obstructive sleep apnea include cardiovascular disorders, such as myocardial infarction and hypertension, stroke, sudden death and difficult blood sugar control related to diabetes mellitus. The current main treatment options include body weight loss, continuous positive airway pressure, oral appliances and surgical treatment. The effects of pharmacotherapy on sleep apnea continue to be controversial and supplemental only. Current medications for sleep apnea mainly act through reducing risk factors, treating predisposing endocrine disorders, improving residual sleepiness post management and controlling associated hypertension and metabolic disorders.

Areas covered: This article discusses the pharmacotherapy of sleep apnea, including ventilatory stimulants, serotoninergic and REM sleep suppressant agents, acetylcholinesterase inhibitors, medications for predisposing endocrine disorders, stimulants, associated sleep apnea health problems and sleep apnea patient anesthetic precaution. Weight loss is not a direct pharmacological approach and is only briefly mentioned.

Expert opinion: At present, there is no appropriate pharmacological treatment for obstructive sleep apnea. There are adjunct treatments such as anti-allergy treatment, and, if residual sleepiness is present, nonamphetaminic stimulants can help. Usage of these stimulants will, however, produce negative effects in an anticipated rate of about 10% of subjects taking these medications.