A pill used to treat epilepsy could help treat sleep apnea, a debilitating sleep disorder that causes temporary interruptions in breathing.
Swedish experts found that patients taking the drug sulthiame had up to a 40 percent reduction in their symptoms, including restless nights and loud snoring.
In addition to causing exhaustion, sleep apnea can increase your risk of life-threatening diseases like high blood pressure, stroke and type 2 diabetes.
Current treatment involves patients wearing an uncomfortable mechanical mask while they sleep that pumps fresh air into their nose and mouth.
The usual treatment for obstructive sleep apnea is for the patient to wear a mechanical mask while sleeping that pumps fresh air into the nose and mouth. File image
But many patients find the machines uncomfortable and difficult to use, leading experts to look for alternative treatments.
One of them is sulthiame, which although used primarily as a medicine for epilepsy, also improves breathing by stimulating the muscles of the upper airways.
Professor Jan Hedner from Sahlgrenska University Hospital and the University of Gothenburg in Sweden presented the results of a “landmark” clinical trial of the drug in almost 300 patients with obstructive sleep apnea.
The patients, who came from Spain, France, Belgium, Germany and the Czech Republic, were no longer able to use the special masks that are usually used for patients with obstructive sleep apnea.
Participants underwent tests to examine their breathing, blood oxygen levels, eye movements, and brain and muscle activity while they slept at the start of the trial to establish a baseline.
They were then divided into three groups. Three of them were given a daily tablet of sulthiame in one of three doses: 100 mg, 200 mg or 300 mg.
The final group was given a placebo to act as a control.
Participants then underwent the same sleep tests at four weeks and at the conclusion of the 12-week trial to explore the impact of the drug.
Researchers found that those taking the drug had fewer pauses in their nighttime breathing and higher blood oxygen levels while they slept.
The effect observed was stronger at higher doses, with patients taking the 300 mg tablet having a nearly 40 percent reduction in these breathing pauses, compared with 18 percent at the lowest dose.
Patients taking the drug also reported feeling more rested when surveyed by researchers.
The trial results, which have yet to be peer-reviewed, also found that sulthiame’s side effects, including tingling, fatigue and nausea, were generally mild to moderate among the groups taking the drug.
Professor Hedner said the results opened up a potential treatment for patients who previously had no alternative to standard face masks.
“Many people find it difficult to use these machines long-term, so alternative treatments need to be found,” he said.
‘Although sulthiame is already available as a treatment for childhood epilepsy, we still need to conduct a phase III study to confirm the beneficial respiratory effects of this drug in a broader group of patients with OSA (obstructive sleep apnea).’
Professor Sophia Schiza, director of the European Respiratory Society on sleep-related breathing disorders and an expert in respiratory and sleep medicine at the University of Crete, who was not involved in the study, welcomed the findings.
“Many of us know that we snore or that our partner snores. If snoring is accompanied by other symptoms, such as waking up often during the night, feeling tired and/or sleepy during the day, then it’s time to talk to a doctor,” she said.
‘This is one of the first studies to suggest that drug treatment might help some patients, and the results are promising.
“We need to continue testing sulthiame and other treatments to understand their long-term effects, including side effects. For example, we’d like to see if the treatment can help lower blood pressure and prevent cardiovascular disease in people with obstructive sleep apnea.”
Although estimates vary, charities have said obstructive sleep apnoea affects around 10 million people in the UK and men are twice as likely to be affected as women.
However, they add that of that total, less than a million are actually diagnosed with the disease.
Although more commonly used in Europe, sulthiame is not routinely used on the NHS because it is an unlicensed medicine in the UK.
This means that while it can be used, doctors who want to prescribe it must go through additional approval processes and it is only used when other medications have failed.
OpenPrescribing, an NHS-backed data source, shows sulthiame was prescribed 100 times in England between January and June this year, the latest figures available.
The average cost of the drug was just under £260 per pack or about £4 per pill.