In a perfect world all of our patients would listen to their physician and follow his directions. I think we can all agree that the world is far from perfect.

When it comes to trying to get our patients to go along with the recommended therapies for their particular problem there are often road blocks. We call these problems of acceptance and adherence.

Nowhere is this more apparent than with patients who need CPAP to control their sleep apnea. Those of you who have sleep apnea and use a CPAP machine know what I am talking about. There is clearly a period of adaptation when using this device.

Research physicians are obviously aware of the problems of acceptance and adherence when it comes to the treatment of sleep apnea. Recently, an implantable pacing device has been developed to help control the muscles in the back of the throat during sleep to help prevent the obstruction they are causing.

To use this device, however, patients need to have a surgical procedure to connect the pacer to the nerves in the neck which control the back of the throat.

Most recently, researchers have been looking at certain medications which may activate the muscles in the throat to prevent them form collapsing the upper airway when sleeping.

There are no approved pharmacologic agents approved for sleep apnea. I wrote this article to tell our sleep apnea patients that we can identify with your complaints and that physician researchers have heard you as well