Pills and potions are often seen as the most desirable solution for many ailments. Although a lot of people don’t relish the idea of being on the receiving end of a needle, injected drugs can work well too.
However, you may be surprised to learn that, in the case of sleep apnea, medications are not generally a primary treatment recommendation.
That’s not to say medications are totally without value. When an additional problem, such as asthma or lung disease, is making sleep apnea worse, the right medication can be a good addition to an existing sleep apnea treatment.
Nevertheless, as a key player in the treatment of sleep apnea, Big Pharma has yet to come up with a medication that gets the job done.
What Is Sleep Apnea?
Sleep apnea is a condition that’s often associated with snoring. However, although people who have obstructive sleep apnea (OSA) often snore, people who have central sleep apnea (CSA) generally do not.
An apnea describes any period of time when normal breathing stops. If you were to hold your breath for 10 seconds, you would experience a 10-second apnea caused by a voluntary decision to stop breathing.
If you were to swallow something that stuck in your throat and made you choke, that would cause an apnea too and it would last until you or someone else managed to remove the obstruction. Obviously, if the obstruction was not removed, life would cease.
As with choking, sleep apnea involves a cessation of breathing that is out of our control. Fortunately, the body normally senses the disruption, wakes up, and respiration resumes.
Many people who have sleep apnea have up to 100 apneas per hour. Some people have slightly more. Multiple sleep interruptions of this nature can cause a multitude of problems.
As well as causing extreme daytime fatigue, sleep apnea can also contribute to:
- Poor memory
- Mental confusion
- Acid reflux
- Weak immune function
- High blood pressure
- High cholesterol
- Heart failure
- Loss of libido
- Liver problems
Although they may feel tired and unwell, many people do not realize they have sleep apnea until their partner is awoken by their snoring and notices the irregularities in breathing.
Needless to say, it’s possible to treat acid reflux and depression with the right medication. The same can be said for many of the other problems but tackling a symptom is not the answer. You need to target the root cause.
What the Research Shows
Researchers have experimented with various ways of using drugs to target the factors that cause sleep apnea.
Unfortunately, although the theory is often sound, things that work well in theory do not always work in the real world.
For instance, CSA happens when the brain doesn’t send the signal responsible for breathing. In theory, it should be possible to treat this type of sleep apnea by using a medication that sparks up the signal.
OSA happens when the airway becomes obstructed. This often happens when the muscle in the throat relax during sleep. In theory, it may be possible to develop a medication that prevents the muscles from sagging. Research does not suggest any of the pharmaceutical companies have managed to develop such a drug yet.
When you are overweight, the presence of excess fat can push on the airways making them more likely to close. So, weight-loss drugs have theoretical value in this area.
However, such drugs will only work if you have the right diet, and let’s face it, if your diet is right you probably won’t need the drug.
Eszopiclone is a sedative that’s often distributed under the Lunesta brand name. Doctors generally prescribe it as a treatment for insomnia.
In 2007, researchers decided to explore the value of the medication as a possible treatment for obstructive sleep apnea. The results of the study appeared in Sleep Medicine (Volume 8, Issue 5).
The study participants were aged 35-64 and had mild to moderate obstructive sleep apnea.
During the study, the participants got eszopiclone (3 mg) or a placebo. The data shows the drug had no noticeable effect.
However, researchers at Harvard conducted a follow-up study that’s a little more promising. The data shows eszopiclone (3 mg) reduced the number of apneas. But only among people with low arousal thresholds.
At most, the Harvard study, which ran for one night only, suggests a need for further resarch. It does not support using eszopiclone as a sleep apnea medication.
Desipramine is an anti-depressant that’s often sold under the Norpramin brand name.
Research published in the European Respiratory Journal in November 2016 (volume 48, issue 5), suggests desipramine may offer slight potential as a sleep apnea medication but only for people with limited muscle function.
The reduction in apneas, among the individuals concerned, may have been because the drug enhances nerve signaling sufficiently to increase the activity of the tongue and the muscles in the throat.
Atomoxetine and Oxybutynin
Atomoxetine is a drug that’s often used as a treatment for attention deficit hyperactivity disorder. Oxybutynin reduces muscle spasms. It’s a popular treatment for overactive bladder.
The results of a small, two-night study suggest a combination of the two drugs (80 mg atomoxetine plus 5 mg oxybutynin) may have potential value as a sleep apnea medication.
Twenty volunteers took part. With the placebo, there was an average of 28.5 airway blockages per hour. The drug combination reduced this to just 7.5.
The results are promising because the drug combination appears to be effective across the board. However, there were only 20 participants and the study was short.
Could a combination of atomoxetine and oxybutynin be an effective sleep apnea medication? Possibly. Without longer studies, involving more people, it’s still too early to say.
The study is available in the American Journal of Respiratory and Critical Care Medicine (volume 199, issue 10), published in August 2018.
At the moment CPAP machines continue to be the best option for most people suffering from OSA.
Although it’s possible the pharmaceutical industry may develop viable sleep apnea medications in the future, it’s unlikely to do so any time soon. A lot of research is needed. It’s still early days, but who knows what the future may hold?