A pill used to treat epilepsy could help treat sleep apnea, a debilitating sleep disorder that causes temporary breathing difficulties.
Swedish experts found that patients who took the drug sulthiamine experienced up to 40 percent fewer symptoms, including restless nights and loud snoring.
Sleep apnea can not only cause exhaustion, but also increase the risk of fatal conditions such as high blood pressure, stroke and type 2 diabetes.
The current treatment consists of wearing an uncomfortable mechanical mask while the patient sleeps. This mask pumps fresh air into the nose and mouth.
The typical treatment for obstructive sleep apnea involves the patient using a mechanical mask that pumps fresh air into the nose and mouth while sleeping.
However, many patients find the devices uncomfortable and difficult to use, leading experts to look for alternative treatments.
One of these is sulthiamine, which is mainly used as an anti-epileptic drug, but also improves breathing by stimulating the muscles in the upper airways.
Professor Jan Hedner from Sahlgrenska University Hospital and the University of Gothenburg in Sweden presented the results of a ‘gold standard’ 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, could no longer use the special masks typically used for patients with obstructive sleep apnea.
At the start of the trial, participants underwent tests to examine their breathing, blood oxygen levels, eye movements, and brain and muscle activity during sleep to establish a baseline.
They were then divided into three groups. Three of them were given a sulthiamine tablet daily in one of three dosages, 100 mg, 200 mg or 300 mg.
The last group received a placebo as a control.
Then, at the end of the study, after four weeks and at the end of the study, the participants underwent the same sleep tests to examine the effect of the drug.
Researchers found that people who took the drug had fewer pauses in breathing at night and had higher oxygen levels in their blood while they slept.
The observed effect was greater at the higher doses. In patients taking the 300 mg tablet, there was a reduction of almost 40 percent in breathing pauses, compared to 18 percent at the lowest dose.
Patients who took the drug also reported feeling more rested in a study by the researchers.
The study results, which have yet to be peer-reviewed, also found that sulthiamine’s side effects, including tingling, fatigue and nausea, were generally mild to moderate in the groups taking the drug.
Professor Hedner said the results provide a potential treatment for patients who previously had no alternative to standard masks.
“Many people find it difficult to use these devices long-term, which is why there is a need for alternative treatments,” he said.
‘Although sulthiamine is already available as a treatment for epilepsy in children, we still need to conduct a phase III study to confirm the beneficial respiratory effects of this drug in a larger group of patients with OSA (obstructive sleep apnea).’
Professor Sophia Schiza, head of the European Respiratory Society’s sleep-related breathing disorders group and an expert in respiratory and sleep medicine at the University of Crete, was not involved in the study and welcomed the findings.
“Many of us know that we or our partner snores. If snoring is accompanied by other symptoms, such as waking up frequently 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 can help some patients, and the results are promising.
‘We need to continue testing sulthiamine and other treatments to understand their long-term effects, including any side effects. For example, we want to see if the treatment can help lower blood pressure and prevent cardiovascular disease in people with OSA.’
Although estimates vary, charities have suggested that obstructive sleep apnea affects around 10 million people in the UK, with men being affected twice as often as women.
However, they add that less than 1 million of this total are actually diagnosed with the condition.
Although sulthiamine is more commonly used in Europe, it is not routinely used in the NHS as the drug is not licensed in the UK.
This means that the drug can be used by doctors who want to prescribe it, but it has to go through an additional approval process and is only used if other drugs don’t work.
OpenPrescribing, an NHS-supported data source, shows sulthiamine was prescribed 100 times in England between January and June this year, according to the most recent figures available.
The average price of the drug was just under £260 per packet, or around £4 per pill.