A good night’s sleep

A PILL that combats snoring could be the secret to a good night’s sleep for millions of couples.
The once-a-day pill slashed snoring rates by almost 70 per cent in a small U.S. trial. Now, larger studies are planned to see if the drug could be a breakthrough in the treatment of sleep apnoea, the snoring-related condition that affects an estimated three million people in Britain.
Initial results from a six-month study involving 45 patients suggest the new drug could be the first pill to tackle snoring.
If so, it may also help to reduce the risks of high blood pressure and heart disease linked with sleep apnoea.
Between 10 and 30 per cent of adults have sleep-related breathing disorders.
Obstructive sleep apnoea is one of the most common, estimated to affect 4 per cent of men and 2 per cent of women. It is most common in the over-40s, though it can affect all ages, including children.
The condition occurs as a result of the narrowing of the airways. As sleep begins, the muscles in the airway relax.
For most people this does not pose a problem, but for those with sleep apnoea it leads to a complete collapse that shuts off breathing for at least ten seconds.
Once the brain realises breathing has stopped, it sends out a signal for the airway muscles to contract again. This opens the airway and the sufferer normally wakes with a jolt and a snore.
In mild sleep apnoea, this happens about once every ten minutes. If it’s severe, sleep can be disturbed every couple of minutes. Very few people remember waking up at all because they fall asleep again within seconds.
Yet the cumulative effect is that they,  and their partners, feel exhausted during the day, putting them at increased risk of accidents.
Sleep apnoea is particularly common in middle-aged men who are overweight, as excess fat around the neck puts pressure on the upper airways during sleep.
Treatment normally begins with a weight loss plan. However, many patients end up needing a therapy called nasal Continuous Positive Airway Pressure, or CPAP. This involves wearing a mask over the nose and mouth during sleep.
The mask is attached to a machine that increases the pressure of the air being inhaled. This prevents the airway from collapsing, improves sleep quality and leads to better concentration during the day.
The treatment is very effective, although some people find the mask cumbersome. Since it does not cure the condition, it must be worn every night.
Other devices include special dental splints, which are worn at night in much the same way as a mouth-guard. These work by pulling the lower jaw forward so that the airway cannot collapse.
The new pill is regarded, by some experts, as the holy grail of snoring therapy.
The new drug, called Qnexa, was developed as a weightloss medicine. It contains a mixture of a stimulant drug called phentermine and an anti-epilepsy drug called topiramate.
Researchers noticed an added benefit when they tested volunteers to measure the effects on sleep apnoea.
Over the course of the trial, which involved men and women aged 30 to 65, the number of times their sleep was disrupted by snoring-related problems dropped from an average of 46 times an hour to just 14.
At the same time, they lost an average of 10 per cent of their body weight and saw a significant drop in blood pressure.
Vivus Inc, the California drug firm that developed Qnexa, says it hopes to get it licensed to treat sleep apnoea.
Professor Jim Horne, a specialist in sleep medicine at Loughborough University, said: “Around 50 per cent of obese people suffer sleep apnoea to some degree,” he says.
“When they lie down in bed, their muscles relax and then the fat around their neck compresses the airway even further. It’s possible this drug helps by triggering weight loss.
“Or it might be that it somehow makes the throat muscles a bit more taut.
“We won’t know whether it is any use to habitual snorers who are not overweight until more research has been carried out.”  – www.dailymail.co.uk