Epilepsy drug could reduce sleep apnoea symptoms, study finds

An epilepsy drug could help prevent the breathing of patients with sleep apnoea from temporarily stopping, according to research.
Obstructive sleep apnoea is a common breathing problem that affects about one in 20 people, according to the National Institute for Health and Care Excellence in England. Patients often snore loudly, their breathing starts and stops during the night and they may wake up several times. Not only does this cause tiredness but it can also increase the risk of high blood pressure, stroke, heart disease and type 2 diabetes.
An international study has identified that an epilepsy medication is associated with a marked reduction in sleep apnoea symptoms.
The findings, presented at the European Respiratory Society Congress in Vienna, Austria, demonstrated there were possible options for those unable to use mechanical breathing aids such as continuous positive airway pressure (Cpap) machines.
Prof Jan Hedner, from Sahlgrenska university hospital and the University of Gothenburg in Sweden, said: “The standard treatment for obstructive sleep apnoea is sleeping with a machine that blows air through a face mask to keep the airways open. Unfortunately, many people find these machines hard to use over the long term, so there is a need to find alternative treatments.”
The researchers conducted a randomised controlled trial of almost 300 obstructive sleep apnoea patients in Belgium, the Czech Republic, France, Germany and Spain who did not use the Cpap machines. They were divided into four groups and given one of three strengths of sulthiame or a placebo.
The study measured patients’ breathing, oxygen levels, heart rhythm, eye movements, as well as brain and muscle activity while asleep, at the start of the trial, after four weeks and after 12 weeks.
It found after 12 weeks, those taking sulthiame had up to 50% fewer occasions where their breathing stopped and higher levels of oxygen in their blood during sleep. The effects were most marked in the highest doses of the drug.
Hedner said the findings suggested sulthiame could be an effective treatment for the condition and that a bigger study was needed to confirm the beneficial respiratory effects of the drug on a larger group of sleep apnoea patients.
Erika Radford, the head of health advice at Asthma + Lung UK, said the findings were a first step in moving away from breathing equipment worn while asleep to a drug-based treatment. “This potential alternative to the current main treatment would make it easier for people to manage their condition,” she added.
Dr Sriram Iyer, a consultant respiratory and sleep physician and president-elect of the Royal Society of Medicine’s sleep medicine section, said: “This is an important study highlighting that drug therapy for sleep apnoea is not far off from being a reality.”
While more studies would examine the long-term benefits, any side-effects and whether there are specific types of patients that would benefit more from treatment, it was “vitally important we don’t forget that sleep apnoea is, in the majority of cases, linked to obesity and addressing this should be the priority”, she said.