A Pill for Sleep Apnea Could Be on the Horizon 56
Promising Phase 3 trial results from Apnimed suggest a potential game-changing oral pill for sleep apnea could offer a simpler, more tolerable alternative for keeping airways open during sleep. The New York Times reports: For decades, the primary treatment for sleep apnea has been continuous positive airway pressure (or CPAP). Before bed, those with the condition put on a face mask that is connected to a CPAP machine, which keeps the airway open by forcing air into it. The machines are effective, but many find them so noisy, cumbersome or uncomfortable that they end up abandoning them. Now, a more appealing option may be on the way, according to a news release from Apnimed, a pharmaceutical company focused on treating sleep apnea. On Wednesday, the company announced a second round of positive Phase 3 clinical trial results for a first-of-its-kind oral pill that can be taken just before bedtime to help keep a person's airway open.
The full results have not yet been released, or published in a peer-reviewed journal. But the findings build on past, similarly positive conclusions from trials and studies. Sleep experts say that what they're seeing in reports so far makes them think the pill could be a game changer. Dr. Phyllis Zee, a sleep doctor and researcher at Northwestern Medicine who was not involved with the trial, said that if approved, the drug could transform the lives of many. That includes not only those who can't tolerate CPAP machines, but also those who can't -- or prefer not to -- use other interventions, such as other types of oral devices or weight loss medications. (Excess weight is a risk factor for sleep apnea.)
The full results have not yet been released, or published in a peer-reviewed journal. But the findings build on past, similarly positive conclusions from trials and studies. Sleep experts say that what they're seeing in reports so far makes them think the pill could be a game changer. Dr. Phyllis Zee, a sleep doctor and researcher at Northwestern Medicine who was not involved with the trial, said that if approved, the drug could transform the lives of many. That includes not only those who can't tolerate CPAP machines, but also those who can't -- or prefer not to -- use other interventions, such as other types of oral devices or weight loss medications. (Excess weight is a risk factor for sleep apnea.)
results and mechanism (Score:4, Informative)
The drug combines a norepinephrine reuptake inhibitor (which should increase a hormone responsible for the fight-or-flight reflex), and an antimuscarinic, which should relax the airways.
Re: results and mechanism (Score:2)
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Yeah, looks like I got it wrong. "Antimuscarinics block the action of acetylcholine at muscarinic receptors, which can help to increase muscle tone in the upper airway during sleep." I'm not entirely sure how that happens.
Me neither, but I’m suddenly envisioning a crack team of elite opera singers marching to the beat of Bach, stepping in to lead an oddly loud workout routine.
No but seriously, do opera singers suffer from sleep apnea? Or anyone else that can brag about having “muscle tone”?
Drug tests at the Opera? (Score:3)
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My mother was a semi-professional singer. Not going to claim opera, but she sang in choirs that performed at Carnegie Hall and such.
She's been using a CPAP for a decade or more.
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Re: results and mechanism (Score:2)
Didgeridoo players don't get it, the breathing and back pressure makes the throat super fit
Re: results and mechanism (Score:5, Interesting)
I've noticed in the past before I started using a CPAP that if I took amphetamine then took a benzo to sleep I wouldn't have sleep apnea. I have pretty bad sleep apnea without the CPAP, 100+ events an hour.
Yay more medication (Score:2, Flamebait)
It seems to be a default these days that we seek to chemically medicate for every condition, or in fact in some cases without condition (no I'm not talking about vaccines, I'm talking about the people who take an aspirin every day to prevent heart disease while washing it down with a coke)
Also what do you mean CPAP is the primary treatment? Where I live it is the treatment of last resort. MAD is the primary prescribed treatment. I was taken off a CPAP machine and fitted with a MAD and it was such a life cha
Re: Yay more medication (Score:3)
Re: Yay more medication (Score:4, Interesting)
Yes and no. The muscles in your tongue and neck represent the vast majority of apnea cases and they are the ones specifically addressed by MAD. As for scope down your throat, it sounds like your knowledge of the diagnosis dates back to the early 00s. These days it is diagnosed by a small device the size of a heart rate monitor strapped to your chest overnight followed by laryngoscopy if the computer says you have interrupted sleep patterns. If that can't tell what it is (which in the overwhelming majority of cases it can) then it gets more extreme. The days of laying in a sleep clinic strapped to a bunch of machines are either long past, or restricted to the tiny subset of apnea cases which are typically neurological rather than obstructive.
Re: Yay more medication (Score:4, Interesting)
Technology has made some strides there as well... Didn't have to bite down on those decidedly unpleasant metal molds filled with nasty gum. The dentist moved a small wand around in my mouth which created a 3d scan on the fly. Took 3 minutes, results mailed directly to the manufacturer, and the MAD arrived a week later.
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I'm glad the oral device works so well for you, but my BiPAP works great for me. And I have a co-worker who unfortunately can't seem to deal with either of those... so an effective pill might be a game-changer for him.
Different strokes for different folks.
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Oh I'm sure it doesn't work for everyone, it also wasn't my point. My point was that the MAD is the primary treatment now, CPAP and BiPAP is reserved for cases where it doesn't work, can't be tolerated or for the subset of apnea cases which aren't obstructive (neurological apnea is a thing too where the brain just doesn't tell you to breath).
Re:Yay more medication (Score:5, Insightful)
Losing 85 pounds cured my sleep apnea.
No pills or machines required.
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I lost 65 lbs without an effect on my sleep apnea. For me a CPAP machine is necessary.
While this may be true, I'd bet money even with 65lb weight loss, you're still overweight. When I got to within 10lbs of my target medically healthy weight my apnea was cured. And when I gain weight it returns. As long as I maintain a HEALTHY weight it stays gone.
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anecdote != data
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What did she say about you?
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Different strokes for different folks.
I could see "stroke" being one of the side effects of the pill listed in their commercials...
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Yes, because we wouldn't want more treatment options for when the existing ones aren't preferrable for whatever reason.
Blocked? (Score:2)
NYT robot filter blocks the article.
CPAP vs pill (Score:5, Informative)
Re: CPAP vs pill (Score:4, Informative)
Mod parent up.
If the apnea sufferer has zero knowledge about CPAP treatment, and no CPAP-treated buddies to assist, she's likely to have her insurance shove the cheapest option leased machine and mask her way without any information on how to make it a great solution.
I was fortunate in having a great sleep lab tech (does anyone even do sleep labs anymore?) who helped me experiment with masks and let me know more about the treatment before morning.
Decades down the line, my CPAP machines (a really nice, nearly silent home machine and a tiny travel machine) are my most important and beloved sleep pals.
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This.
I'm having a sleep lap study in the coming weeks. It will be my third. Going on my 3rd CPAP (may be a BiPAP this time) in 25 years. So yes they still do them - sleep overnight in a lap with a bunch of sensors on you with someone watching your sleeping and adjusting your CPAP/BiPAP settings throughout the night to come up with the correct settings for the individual.
I took a at-home sleep study weeks ago to look into getting a MAD device (through a company not affiliated with my sleep doctor), but as
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Re: CPAP vs pill (Score:2)
Wow. They had infrared cameras looking at me, checked chest expansion, heartbeat, BP, I think, looked for restless leg, buncha stuff.
Hated the bed, and having them come wake me periodically sucked too, but they got me set up.
I've had 2 labs. The second when a new practice started treating me after a long time unaffiliated with any sleep doc.
CPAP/BiPAP isnt noisy (Score:3)
Fake news: The summary says these machines are noisy. The machine is basically silent, background noise of HVAC is louder. When they are worn without leaks, the mask should be quiet too.
I doubt the pill will be as effective as CPAP/BiPAP but im curious what happens when the patient uses both?
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I doubt the pill will be as effective as CPAP/BiPAP but im curious what happens when the patient uses both?
The doctor ends up with a yacht and a condo?
Overprescribing in the Medicated States of America, is about as recognized (read: sponsored) as social media addiction.
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Fake news: The summary says these machines are noisy. The machine is basically silent, background noise of HVAC is louder. When they are worn without leaks, the mask should be quiet too.
I doubt the pill will be as effective as CPAP/BiPAP but im curious what happens when the patient uses both?
I'll second the fake news thing. I sleep with a CPAP (and have for 25 years), and the one I have now is nearly silent. I have to sometimes pull my mask off slightly to check that it is even on.
I'm sure there are some that are noisy, but that hasn't been my experience. If my mask leaks because it isn't on quite right that makes a lot more noise than my machine does.
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The machine is basically silent
"basically silent" is like saying something is "basically 100% complete" which is to say that it is not.
background noise of HVAC is louder.
Not in my experience. There are many different CPAP machines and many different HVAC units and installations.
You shouldn't go making unilateral statements when it is something that can vary from person to person.
Disfigured skulls and jaws are the problem. (Score:2)
I'm pretty sure a pill isn't going to fix my lobsided skull or my staggered teeth and underdeveloped jaws. A problem evidently linked to wrong post-teething toddler nutrition rampant in modern societies around the world for roughly 200 years. There's even a book on the problem (Jaws: The Story of a Hidden Epidemic) [goodreads.com].
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You spend a lot of time on X, huh?
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I learned about this between children and a younger one currently has wisdom teeth coming in with plenty of room.
Even a healthy dose of Neanderthal genes were no match for the processed "baby food" diet.
most people are too fat! (Score:4, Insightful)
of course this is a very limited sample size, but every one of my friends who had sleep apnea were overweight. Their apnea went away after they lost weight.
Of course that solution doesn't play well with pharmaceutical companies nor medical equipment manufacturers.
By your logic, CPAPs wouldn't sell in Japan (Score:2)
of course this is a very limited sample size, but every one of my friends who had sleep apnea were overweight. Their apnea went away after they lost weight.
I know lots of people with sleep apnea and 10% bodyfat. You're mostly correct, but oversimplifying. Weight loss helps....but I don't really consider women with 20% bodyfat in their 50s overweight..or men with 15% bodyfat at any age. So if you go from 15%, which is skinny with clothes to 10%...which is ripped with great abs....yeah, your sleep apnea may go down...but being super ripped is not even physically possible for the majority of humans and DEFINITELY unrealistic...probably unhealthy as well.
Ce
another pill (Score:2)
If there were other options, they'd do it. (Score:2)
How about a pill to fix an issue and corrects issues. Yet another pill that you must keep taking. Great marketing model. Similar to the GL1's, DOesnt fix your weight but keeps if off if you pay the license fee each month to keep off the weight.
If people are seeking meds to treat a problem, clearly other approaches failed. Sleep Apnea is complex and caused by many things. If it could be fixed by surgery, doctors & insurance companies would be pushing patients to do that. It's safe to assume no responsible person chooses a lifetime of medication as their first choice...and typically, at least in the US, people who are treating medical issues are at least somewhat responsible....the irresponsible morons just never see doctors or push horse pa
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So you're going to tell me the laws of thermodynamics are BS? Eating less and exercising more absolutely COULD fix their weight. Many (most?) people just don't have the discipline to do so. Like it may actually require you feeling hungry and uncomfortable for a period of time, but you will lose weight, because physics/biology. For instance, if you ate zero calories for a few days, I can assure you, weigh
Does it help you... (Score:2)
...by making you choke to death on the pill in your sleep?
Lose weight... (Score:5, Insightful)
When I dropped 20lbs mine was gone. When I gained 10lbs back, it came back. Lost 10lbs... gone again. It was 100% tied to my being overweight.
Yours was 100% weight (Score:2)
My wife has Ehlers-Danlos - weak stretchy connective tissue. It's a spectrum syndrome running from very loose joints on the low end to crippling joint/ligament problems with lots of other stuff thrown in. She's on the low end, thank ghod.
Ehlers-Danlos is highly correlated with sleep apnea that has nothing to do with overweight.
You can buy it OTC today. It's called ephedrine (Score:3)
Atomoxetine, side effects too much for some (Score:2)
Atomoxetiney which is normally prescribed for ADHD is a major component of this study, but the side effects were just too much for many patients. Many ended up using the CPAP to gain relief.
For example for one: blood pressure went from healthy/normal to consistently high, Fatigue never lessened. If anything, it got worse, and was exhausted constantly, Gnarly headaches nearly every day in the afternoon, , Felt anhedonia and didn't care about much of anything. Libido was lessened, and it hurt to orgasm.
fat (Score:2)
Lose weight and your sleep apnea will go away 90% of the time.