The current gold standard for sleep apnea treatment is a CPAP machine, which is intolerable by many. Wouldn’t it be great if a pill could replace a CPAP?
A medication called sulthiame could help people with obstructive sleep apnea (OSA) breathe more easily at night and sleep better overall.
The findings come from a European clinical trial. Researchers say the results suggest the possibility of a drug option for patients who struggle to tolerate CPAP masks.
The study was published in The Lancet. A total of 298 people with moderate to severe sleep apnea participated.
About one quarter received a placebo, while the rest were treated with different doses of sulthiame.
The trial took place across four European countries and followed a double-blind design, meaning neither participants nor researchers knew who was receiving the active drug.
Study Shows Major Reduction in Breathing Pauses
Patients given higher doses of sulthiame experienced up to 47 percent fewer breathing interruptions during sleep compared with the placebo group.
They also had improved oxygen levels overnight.
Sulthiame seems to work by stabilizing the body’s control of breathing and increasing respiratory drive.
This helps reduce the chance that the upper airway collapses during sleep, which is the main cause of obstructive sleep apnea.
This upper airway collapse, which could be complete or partial, can be caused by excess fat, overly relaxed tissue from alcohol intake close to bedtime, inflammation from smoking or naturally large throat structures.
Most side effects from sulthiame that were reported during the trial were mild and temporary.
Jan Hedner, senior professor of pulmonary medicine at the Sahlgrenska Academy, University of Gothenburg, led the study.
She points out in the paper that the results show that OSA can be influenced by a medication. “It feels like a breakthrough,” she says.
The team is eagerly anticipating bigger and longer-duration studies to see how long the effect lasts and to further explore safety of long-term use of the drug.
Many Patients Cannot Tolerate CPAP Treatment
While CPAP technology is a godsend to many patients, others can’t bear the use of it.
They’re in a real bind because not only does untreated OSA lead to daytime drowsiness, which can occur while driving, it can also, over time, cause heart disease, hypertension, type 2 diabetes and stroke.
The most common therapy is continuous positive airway pressure (CPAP), which uses a mask, through which air is blown, to keep the airway open.
You may have heard of other treatments, perhaps surgery to remove excess throat tissue or a custom made device (fashioned by one’s dentist) that keeps the lower jaw moved forward during sleep just enough to keep the airway open.
These treatments can work for milder sleep apnea, and even then, not all of the time.
While CPAP is highly effective even for severe OSA, up to half of patients stop using the device within a year because the mask can feel uncomfortable or disrupt sleep.
Sulthiame is already approved to treat a form of childhood epilepsy. There is hope that it can become a treatment for sleep apnea — which can occur right as you’re falling asleep.
