It seems more and more of us are lacking a good night’s sleep, which is essential to physical and mental wellbeing, but Australian researchers have big dreams of easing a leading cause of poor sleep.
Though it’s difficult to count the number of sleep apnoea sufferers due to a lack of diagnoses, Neuroscience Research Australia (NeuRA) puts the figure at one million Australians. When you include their bedfellows whose nights are often disrupted, you get a picture of just how big a problem sleep deprivation is, and not just for health.
In 2017, Deloitte examined the cost to the economy of the top three sleep disorders – obstructive sleep apnoea, restless legs syndrome and primary insomnia – putting it at a staggering $66 billion every year. That’s enough to keep Treasury up at night.
But NeuRA, an independent, not-for-profit brain research institute based in Sydney, claims to have reduced the severity of sleep apnoea in a study group by at least 30 per cent.
Sleep apnoea occurs when the throat muscles relax during sleep, narrowing the airways to the point of constriction.
Partial or complete obstruction can last from 10 seconds to a minute or more, restricting oxygen intake and starving the brain of oxygen, which triggers sufferers to wake up as often as 100 times or more an hour.
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Long-term exposure to sleep apnoea can increase the chance of cardiovascular disease, dementia and depression, and it has been estimated that sufferers are two to four times more likely to crash a car than the general population.
Sleep apnoea symptoms include:
- loud snoring
- gasping, snorting or choking during sleep
- incidents where you have stopped breathing while sleeping (as reported by another person)
- dry mouth
- fatigue and tiredness
- irritability
- morning drowsiness or headaches
- difficulty paying attention or focusing
- insomnia
- hypersomnia (oversleeping in the daytime).
The main therapy involves wearing a mask to bed – known as Continuous Positive Airway Pressure Therapy (CPAP) – but many find it uncomfortable and half the people who try it find it hard to tolerate.
Despite almost 30 years of research, there are no approved drug therapies to treat the condition, but Professor Danny Eckert, principal research scientist at NeuRA and director of the Adelaide Institute for Sleep Health at Flinders University, believes we’re a step closer after repurposing two existing medications to help treat sleep apnoea.
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The study, funded by the National Health and Medical Research Council of Australia and published this month in the Journal of Physiology, was driven by previous research that showed two classes of medication, reboxetine and butylbromide, were able to keep muscles active during sleep in people without sleep apnoea, and assist their ability to breathe.
Reboxetine, an antidepressant that is also prescribed for attention deficit hyperactivity disorder (ADHD), is slightly wake promoting and reduces REM sleep, while butylbromide (often sold as Buscopan) is a muscle relaxant used to ease cramps.
Prof. Eckert and his team used a multitude of recording instruments to measure whether reboxetine and butylbromide could successfully target the main causes of sleep apnoea.
This included balancing the electrical activity of muscles around the airway, preventing the throat from collapsing during sleep, and improving the regulation of carbon dioxide and breathing during sleep.
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Results showed that these medications did in fact increase the muscle activity around participants’ airways, with the drugs reducing the severity of sleep apnoea by up to one-third.
“Almost everyone we studied had some improvement in sleep apnoea,” said Prof. Eckert.
“People’s oxygen intake improved, their number of breathing stoppages was a third or more less. We were thrilled because the current treatment options for people with sleep apnoea are limited and can be a painful journey for many,” he said.
Researchers plan to refine these types of medications to deliver even greater benefits.
“Next, we will look at the effects of these and similar medications over the longer term. We will assess whether we can harness the benefits of one drug without needing to use them both,” Prof. Eckert said.
“Equally, we will test whether these treatments can be combined with other existing medications to see if we can improve their efficacy even more.”
Do you or a loved one have sleep apnoea? If so, how do you treat it? Why not share your experiences in the comments section below?
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