Drug Trial Shows Promise for First Pill-Based Sleep Apnea Treatment

A European clinical trial has found that the existing epilepsy drug sulthiame can significantly reduce breathing pauses in patients with obstructive sleep apnea — offering hope for a pill-based alternative to CPAP machines.

The study, published in The Lancet, tested sulthiame across 298 patients with moderate to severe sleep apnea in four European countries. Patients receiving higher doses experienced up to 47% fewer breathing interruptions during sleep and showed improved oxygen levels, according to the University of Gothenburg, which co-led the research.

"We've been working on this treatment strategy for a long time, and the results show that sleep apnea can indeed be influenced pharmacologically," said Jan Hedner, senior professor of pulmonary medicine at Sahlgrenska Academy, University of Gothenburg. "It feels like a breakthrough."

The drug works by stabilizing the body's control of breathing and increasing respiratory drive, which helps prevent the upper airway from collapsing during sleep — the primary cause of obstructive sleep apnea. Most side effects in the trial were mild and temporary.

Current standard treatment involves CPAP machines that use pressurized air to keep airways open during sleep. While effective, up to half of patients abandon the device within a year due to discomfort. Sulthiame, already approved for a form of childhood epilepsy, is being repurposed as a potential first direct drug treatment for the condition.