A path is expected to open to treat obstructive sleep apnea, which causes breathing to stop during sleep, with medication. Obstructive sleep apnea is a condition in which the upper airway narrows or becomes blocked during sleep, repeatedly causing temporary pauses in breathing. It occurs more often with older age or excess weight.
A research team led by Winfried Randerath at the University of Cologne in Germany said in the Lancet on Oct. 9 that when the antiepileptic drug sulthiame, used to treat epilepsy, was given to patients with sleep apnea, breathing pauses decreased and sleep quality improved. Sulthiame was developed by Bayer in Germany in the 1950s and has been used in Europe for pediatric epilepsy since the 1960s.
The researchers randomly divided 240 patients with sleep apnea and administered sulthiame 100 mg, 200 mg, 300 mg, and a placebo, respectively, for 15 weeks. Patients who took sulthiame saw breathing pauses decrease by up to 47%.
Sleep apnea occurs when the muscles around the airway relax excessively. The airway narrows, making it hard to breathe. The researchers explained that sulthiame stimulates the sympathetic nervous system to tense the muscles and open the airway. However, some patients experienced headaches as a side effect.
With sleep apnea, it is hard to sleep properly at night and breathing obstruction causes oxygen deficiency. Excessive daytime sleepiness, fatigue, and cognitive decline raise the risk of drowsy driving and accidents. It has a significant impact on daily life. It also increases the risk of diseases such as stroke, hypertension, and type 2 diabetes.
The researchers said, "Patients who took the drug felt less sleepy during the day," and noted, "This shows that sleep apnea can now be treated with medication instead of a CPAP device."
About 1 billion people worldwide experience sleep apnea, but there has been no specific medication. To treat sleep apnea, patients wore CPAP devices on their faces while sleeping. The mask-type CPAP blows compressed air through the nose during sleep to keep the airway from collapsing. However, CPAP devices are inconvenient to use, and half of patients stop within a year.
References
LANCET (2025), DOI: https://doi.org/10.1016/S0140-6736(25)01196-1