A decades-old epilepsy medication may offer new hope for individuals suffering from sleep apnoea, according to research presented this week at the European Respiratory Society (ERS) Congress in Vienna. The study suggests that the drug could provide an alternative treatment for those who struggle with continuous positive airway pressure (CPAP) machines.
Sleep apnoea, a disorder characterized by intermittent breathing pauses during sleep that disrupt oxygen levels, affects approximately 936 million people globally. Of these, about 425 million experience moderate to severe cases. CPAP machines are commonly used to keep airways open and prevent snoring, but many patients find them challenging to use long-term.
“The standard treatment for obstructive sleep apnoea involves using a machine that delivers air through a face mask to maintain open airways,” said Jan Hedner, lead author of the study and professor of respiratory medicine at Sahlgrenska University Hospital in Sweden. “However, many people struggle with the long-term use of these machines, highlighting the need for alternative treatments.”
The study, which involved nearly 300 participants from the Czech Republic, Belgium, France, Germany, and Spain, focused on individuals with obstructive sleep apnoea (OSA) who did not use CPAP machines. Participants were administered either sulthiame, an epilepsy drug that stimulates upper airway muscles, or a placebo.
Over a 12-week period, researchers monitored participants’ breathing patterns, blood oxygen levels, heart rhythm, eye movements, and brain and muscle activity during sleep. Results indicated that those taking sulthiame experienced fewer breathing interruptions and higher blood oxygen levels compared to those receiving the placebo. Additionally, sulthiame users reported reduced daytime sleepiness.
Higher doses of sulthiame were associated with more significant improvements. Participants receiving the highest dose had a 39.9% reduction in the frequency of breathing pauses, while those on the lowest dose saw a 17.8% decrease.
“This suggests that sulthiame could be an effective alternative treatment for OSA, particularly for those who are unable to use mechanical devices,” Hedner stated.
Sulthiame is currently approved in European countries for the treatment of childhood epilepsy. The findings, which have not yet been published in a medical journal, were presented at the ERS Congress by Hedner.
Sophia Schiza, head of the ERS’s sleep disordered breathing group and a professor of respiratory and sleep medicine at the University of Crete, emphasized the need for further research. “Although the results are promising, additional studies are essential to understand the long-term effects of sulthiame and other potential treatments for sleep apnoea symptoms,” Schiza, who was not involved in the study, said.
She also highlighted the importance of addressing obstructive sleep apnoea due to its association with severe health conditions such as high blood pressure, heart disease, and metabolic disorders.
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