First Treatment Drug Discovered for Sleep Apnea
U.S. regulators have given the green light to the first drug treatment for sleep apnea, allowing a weight-loss medication to be used for this condition that impacts millions of Americans.
“This is a major advancement for patients suffering from obstructive sleep apnea,” said Sally Seymour, an official with the U.S. Food and Drug Administration (FDA), during the announcement of Zepbound’s approval for treating moderate to severe sleep apnea in obese adults.
Created by Eli Lilly, Zepbound is already authorized for individuals who are obese or overweight and face related health challenges, such as type 2 diabetes, high cholesterol, or high blood pressure. “Zepbound functions by activating hormone receptors in the intestine to curb appetite and decrease food intake,” the FDA noted. “By facilitating weight loss, studies indicate that Zepbound also alleviates symptoms of obstructive sleep apnea.”
Obstructive sleep apnea (OSA) is a serious condition characterized by repeated breathing interruptions during sleep due to a blocked airway. It disrupts restorative sleep and raises the risk of high blood pressure, stroke, and depression. The American Academy of Sleep Medicine estimates that sleep apnea affects around 30 million adults in the U.S. Traditional treatments for sleep apnea include CPAP machines, which provide a continuous flow of air through a mask to keep airways open.
In two clinical trials, Zepbound demonstrated a reduction in the frequency of sleep apnea episodes, likely attributed to the weight loss achieved by participants. Nearly half of those in the trials showed such significant improvement that they no longer displayed symptoms of sleep apnea.
“This represents a vital step forward in alleviating the burden of OSA and its related health risks,” remarked Patrik Jonsson, a senior executive at Eli Lilly. Zepbound is administered through weekly injections and is recommended in conjunction with a reduced-calorie diet and regular exercise.
The drug is part of a new class of obesity treatments that imitate hormones responsible for insulin secretion, reducing appetite, and slowing down stomach emptying. Other medications in this category include Novo Nordisk’s Ozempic, which has been commonly used since it received U.S. approval in 2017.
What is Sleep Apnea?
Sleep apnea is one of the prevalent but potentially life-threatening conditions, which interfere with breathing during sleep. It is described by the temporary arrest of breath or else by rapid, shallow breaths, which may range from several seconds to one or two minutes. Such disruptions make the individual to wake up momentarily and this results in disrupted and low quality sleep. The currently, sleep apnea is a common condition, which affects millions of persons, however, the number of individuals, who were identified, is still high.
There are three main types of sleep apnea:
1. Obstructive Sleep Apnea (OSA): The most common form, with vocal cord vibrations – caused by the relaxation of throat muscles that block the airway.
2. Central Sleep Apnea (CSA): A less common type through which the brain is unable to relay appropriate signals to the muscles that govern breathing.
3. Complex Sleep Apnea Syndrome: Known also as treatment-emergent central sleep apnea, this is a condition whereby an individual has both OSA and CSA.
If the condition persists untreated, sleep apnea results in the development of severe diseases of the heart and blood vessels, diabetes, and cognitive disorders.
Causes of Sleep Apnea
There are several causes of having sleep apnea. These vary depending on the type:
Obstructive Sleep Apnea
– Excess Weight: Obesity is considered as an important aspect because excess fat suppresses the airway around the neck.
– Anatomical Features: Amplification of the tonsils, the thickness of the neck or small mandible also affects the size of the airway.
– Aging: With advancing age, the muscles which maintain the patency of the airway attract flaccidity impelling the likelihood of occlusion.
– Smoking and Alcohol Use: These can either relieve the throat muscles or cause inflammation thus creating worsened airway blockage.
– Family History: It might be that some people are more vulnerable due to their genetic profile.
Central Sleep Apnea (CSA)
– Neurological Conditions: Neurological conditions including the stroke, brain infections or Neurodegenerative illnesses are also known to compromise breathing regulation.
– Heart Disorders: Such diseases as congestive heart failure can cause cardiovascular sleep apnea secondary to intensification of CSA.
– High Altitudes: Sleeping at high altitude where oxygen availability is lower is likely to precipitate CSA episodes.
Symptoms of Sleep Apnea
Common symptoms of sleep apnea include:
– Snoring (but not as loud, and much more often in OSA)
– Sleep apnea or episodes of stopped breathing during sleep that are observed by a bed partner
SNS by the presence of gasping or choking during sleep
; Alertness at night and Sleepiness
– Difficulty concentrating
– Morning headaches
– Irritability or mood swings
Diagnosis of Sleep Apnea
Sleep apnea is typically diagnosed through:
– Sleep Studies: Polysomnography is a test performed in a sleep lab that records the individual’s breathing, heart rate, oxygen, and other physiological aspects of the sleep.
– Home Sleep Apnea Testing (HSAT): A smaller home-based version of polysomnography.
Symptom assessment may also involve one’s past medical history, physical examination, questionnaires such as the Epworth sleepiness scale.
Management of Sleep Apnea
The management of sleep apnea as a condition depends partly on its severity and type. Treatment options include:
Lifestyle Changes
– Weight Loss: Weight loss has been found equivalent to possible decrease in the severity of OSA.
– Avoiding Alcohol and Sedatives: These substances, which causes the muscles surrounding the throat to loosen, aggravates apnea.
– Sleep Position Adjustment: Laying on the side rather than the back will help to avoid blockage of the airways.
– Quit Smoking: Smoking in fact increases inflammation and the condition where the airway will retain fluid.
Medical Devices
– Continuous Positive Airway Pressure (CPAP): A device that provides a constant flow of air which maintains patency of airway during sleep. In this condition, it remains probably the most beneficial solution.
– BiPAP and APAP Machines: Devices that vary air pressures for the individual and are considered to be alternatives to CPAP.
– Oral Appliances: Ornaments that have to be custom made to include splints for the jaw and tongue that realign them to ensure the airway is clear.
Surgical Options
– Uvulopalatopharyngoplasty (UPPP): Resects the redundant tissue in throat.
– Genioglossus Advancement: Advances the position of the tongue muscle in order to stop collapsing of the airway.
-Tracheostomy: The final resort operation to form an airway from the outer surface of the neck.
Treatment for CSA
Inpatient, including treatment of primary diseases such as heart failure or neurological diseases.
-Treatment with ASV devices that self titrate based on patient breath patterns.
Second; supplemental oxygen therapy.
EFFECTS OF UNPROPERLY MANAGED SLEEP APNEA
If left unmanaged, sleep apnea can lead to:
High blood pressure and heart disease
– Stroke
– Type 2 diabetes
– Depression and anxiety
and often a decline in life quality resulting from constant exhaustion.
Conclusion
Sleep apnea is a severe, but not an uncontrolled disease. Knowledge of its origin, manifestation, and management is important to enhance the patient’s quality of life as to reduce risk of morbidities. Anyone who sleeps or has a loved one who snores heavily, and perhaps has any of the above symptoms, should consult a doctor. It is always advisable to seek early treatment because it help improve sleeping habits and general health.