Epilepsy drug could be key to treating sleep apnea

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Sleep apnea is a widespread problem that affects many people, regardless of age. Besides reducing the quality of sleep, it can cause you to snore loudly, which would disturb not only you but also the people around you.

There are two types of sleep apnea: obstructive and central. Obstructive sleep apnea is the most common type, which causes you to stop breathing during sleep. This causes your muscles to relax and the soft tissues to block the airways, leading to short pauses in breathing.

The most recommended solution for the disorder is to use a CPAP (continuous positive airway pressure) machine which regularly applies airflow to keep your airways open at night and allow you to breathe. Unfortunately, wearing a mask all night isn’t the most comfortable option. Other than that, the alternatives are mouth guards and a variety of surgical options.

But now researchers have discovered a potential new treatment that can eliminate mechanical treatments such as CPAP machines and mouth guards. A first clinical trial conducted by a team of researchers has shown that sulthiame, a drug used to treat epilepsy, relieves sleep apnea. The results of the trial have been published in the American Journal of Respiratory and Critical Care Medicine.

How effective is it?

The trial included 60 people with moderate or severe sleep apnea. The subjects were divided into three groups according to the doses they were given: high, low and placebo. The results showed that the drug boosted blood oxygenation and reduced pauses in breathing by inhibiting an enzyme that serves to maintain carbon dioxide balance in the body.

“For just over a third of patients in the study, only half of their breathing pauses remained, and in 1 in 5 the number dropped by at least 60%,” said the lead researcher. , Dr. Jan Hedner, Professor of Pulmonary Medicine. at the University of Gothenburg in Sweden.

Although the drug was found to be relatively safe, some subjects dropped out of the trial due to reported side effects such as headaches, a feeling of pins and needles on the skin, and shortness of breath. On top of that, the current results only promise “a partial solution” since some patients barely responded to the drug while others responded well.

“I don’t see it necessarily being a complete solution or a complete substitute for a therapy like CPAP (continuous positive airway pressure),” said Dr. Jonathan Jun, a sleep medicine expert at Johns Hopkins Hospital in Baltimore. Told American News.

Now the research team has expanded the trials to 400 subjects for the next phase, which should be finalized by the end of the year or early next year.

So far, the effectiveness of the drug has not been proven and trials are ongoing, but the study is still promising as it could lead scientists to come up with new combination therapies.

Abstract:

Rationale: Current treatments for obstructive sleep apnea (OSA) are limited by insufficient efficacy, compliance or tolerability. Effective pharmacological treatment of OSAS is warranted. Inhibition of carbonic anhydrase (CA) has been shown to improve OSA. Objective: To explore the safety and tolerability of the CA inhibitor sulthiame (STM) in OSA. Methods: A four-week, double-blind, randomized, placebo-controlled, dose-guiding trial in patients with moderate/severe OSA intolerant of positive airway pressure therapy. Measurements and Results: Intermittent paresthesias were reported by 79, 67, and 18% of patients receiving STM 400 mg (N=34), STM 200 mg (N=12), or placebo (N=22), respectively. Dyspnea was reported only after 400 mg of STM (18%). Six patients in the higher dose group withdrew due to an adverse event. There were no serious adverse events. STM reduced the apnea-hypopnea index (AHI) from 55.3 to 33.1 events/h (41.0%) in the 400 mg group and from 61.2 to 40.7 events/h ( 32.1%) after 200 mg (p

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