“We still need to know whether patients’ improvement is due to weight loss or to the effect of the drug, which is fundamental.”
Joaquin Duran Cantolla
Pulmonologist, director of the sleep department of the Eduardo Anitua clinic, Vitoria
In recent years, the industry has tested more than a hundred possible sleep apnea drugs, all of which have failed. However, it now finally appears that the first pharmacological treatment for this approach is about to emerge. … a disease discovered, as happened with penicillin, almost as a result of a happy coincidence. An American team has shown that the famous diabetes therapy that has proven effective against obesity, tirzepatide (from the famous Ozempic family), also appears to correct the breathing problems that cause some snoring. If it ultimately proves as effective as it promises, the new alternative will allow it to treat exclusively obese patients, who make up 60% of those affected.
Sleep apnea is one of the biggest health problems of our time. Experts estimate that more than 10 million Spaniards and about 936 million people in the world suffer from it. Most of them, an estimated 90%, are unaware that they are living with serious health problems. Snoring occurs when the throat muscles relax so much that they block the air passage and completely or partially block breathing. As a result, they sleep poorly at night and suffer from headaches and drowsiness during the day. Worst of all, they have an increased risk of vascular diseases, especially cerebral infarctions.
Today, several treatment methods are available to patients, but all of them are palliative. Given this picture, the search for a cure has become almost an obsession for science. “We need drugs that specifically strengthen the dilator muscles of the throat,” explains pulmonologist Joaquin Duran Cantolla, director of the sleep unit at the Eduardo Anitua Clinic in Vitoria.
Goodbye CPAP machine
The task is not easy, so the expert is as cautious as he is hopeful about the research known today. “We have very positive news signed by a great team and published in one of the most prestigious journals in the world, the New England Journal of Medicine.” We are missing details that we learn,” he assesses.
Some already know. The research team recruited 469 patients from nine countries, including the US, Australia and Germany, all of whom were diagnosed with clinical obesity. Half of them received 10 to 15 grams of tirzepatide by injection over 52 weeks. There were those who continued to use the standard treatment for sleep apnea—that is, positive pressure therapy—and those who did not. This solution, which is the most common, consists of a machine called CPAP, equipped with a tube and a mask, that takes air from the room where you sleep and uses it to keep the affected person’s airway open.
Joaquin Duran Cantolla
Pulmonologist, director of the sleep department of the Eduardo Anitua clinic, Vitoria
The study confirmed that the drug significantly reduced the number of sleep interruptions, a key indicator for measuring the severity of apnea. Moreover, the improvement was “much greater” in participants taking the drug than in those taking placebo, to the point that in some cases “CPAP therapy was no longer required.”
“Important milestone
Pharmacological treatment has also improved other aspects associated with obstructive sleep apnea, such as reducing the risk of vascular disease and improving body weight. There were no serious side effects, the most common being mild stomach problems. “This study marks an important milestone in the treatment of the disease and offers a promising new therapeutic option that addresses both respiratory and metabolic complications,” said study lead author Atul Malhotra from the University of San Diego School of Medicine, California.
If it proves as effective as advertised, the drug could benefit up to 60% of obese patients. Traditionally, Durán Cantolla explained, it was believed that this was a pathology characteristic only of overweight people, but reality has shown that almost half of them are not. The thin ones will have to wait for now.
CPAP is the gold standard treatment for sleep apnea, although not all patients tolerate it. In some very specific cases, the problem is treated with surgery, and in others, with mandibular advancement devices or positional therapy equipment that forces the affected person to sleep on their side. The latter are used when apnea occurs only during sleep on the back. “We still need to know whether the therapy itself works or is a consequence of patients losing weight,” warned clinic expert Eduardo Anitua. “If it’s the former, then we’re lucky. The situation is expected to improve and gradually other patients will benefit from this,” he said hopefully.
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