Epilepsy medication may be key to treating sleep apnea

Sleep apnea is a common problem that affects many people, regardless of age. Besides reducing sleep quality, it can also cause you to snore loudly, and this will disturb not only you but those around you as well.

There are two types of sleep apnea: obstructive and central. The most common type is obstructive sleep apnea, which causes you to stop breathing while you sleep. It causes your muscles to relax and the soft tissues block your airway, causing short pauses in breathing.

The most recommended solution to the disorder is to use a CPAP (continuous positive airway pressure) machine that uses a steady stream of air to keep the airway open during the night and enable you to breathe. Unfortunately, wearing a mask overnight is not 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 could eliminate mechanical treatments such as continuous positive air pressure devices and mouth guards. An early clinical trial conducted by a team of researchers demonstrated that sulthiame, a drug used to treat epilepsy, relieves sleep apnea. The results of the experiment were published in American Journal of Respiratory and Critical Care Medicine.

How effective is that?

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 enhanced blood oxygenation and reduced periods of respiratory arrest by inhibiting an enzyme that maintains carbon dioxide balance in the body.

“For just over a third of patients in the study, only half of the pauses in breathing remained, and in 1 in 5, the number was reduced by at least 60%,” said lead researcher Dr. Jan Hedner, professor of pulmonary medicine. at the University of Gothenburg in Sweden.

Although the drug has been shown to be relatively safe, some people have discontinued the trial due to reported side effects such as headache, tingling sensations on the skin, and shortness of breath. In addition, the current results only promise a “partial solution” because some patients barely responded to the drug while others performed well.

“I don’t see that this would necessarily be a complete solution or a complete replacement for a treatment like CPAP (continuous positive airway pressure),” said Dr. Jonathan John, an expert in sleep medicine at Johns Hopkins Hospital in Baltimore. US News.

Now, the research team has expanded the trials to 400 people for the next phase, which is expected to be completed by the end of the year or early next year.

So far, the drug’s efficacy has not been proven, and trials are underway, but the study is still promising because it may prompt scientists to devise new combination therapies.

a summary:

Rationale: Current treatments for obstructive sleep apnea are limited by insufficient efficacy, compliance, or tolerability. Effective pharmacotherapy in OSA is justified. Carbonic anhydrase (CA) inhibition has been shown to alleviate obstructive sleep apnea. OBJECTIVE: To explore the safety and tolerability of a CAsulthiame (STM) inhibitor in OSA. METHODS: A four-week, randomized, double-blind, placebo-controlled trial in patients with moderate/severe OSA who cannot tolerate positive airway pressure therapy. MEASUREMENTS AND RESULTS: Intermittent paresthesia was reported by 79, 67, and 18% of patients who received 400 mg STM (N = 34), 200 mg STM (N = 12), or placebo (N = 22), respectively. Dyspnea was only reported after 400 mg 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/hour (41.0%) in the 400 mg group and from 61.2 to 40.7 events/hour (32.1%) after 200 mg (p < 0.001, respectively). Corresponding placebo values ​​were 53.9 and 50.9 events/hour (5.4%). The AHI reduction threshold of 50% was reached at 40% after 400 mg, 25% after 200 mg, and 5% after placebo. The mean overnight oxygen saturation improved by 1.1% after 400 mg and 200 mg (p < 0.001 and p = 0.034, respectively). Patient-related findings remain unchanged. CONCLUSIONS: The STM demonstrated satisfactory safety profiles in moderate/severe OSA. STM reduced OSA by more than 20 events/hour, one of the strongest reductions reported in an OSA drug trial. Extensive clinical studies of STM in OSA are warranted. Clinical trial registration is available at https://www.clinicaltrialsregister.eu/https://www.clinicaltrialsregister.eu/, ID: 2017-004767-13. This article is open access and distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivatives License 4.0 (http://creativecommons.org/licenses/by-nc-nd/4.0/)

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