The largest and longest trial to date that evaluated an oral medication for obstructive sleep apnea yielded positive results, according to research in Chicago. Dronabinol, a synthetic substitute for THC, was useful in reducing apnea and reducing sleepiness in 73 adult patients.
The study, published in the journal Sleep was born from the need to develop more usable sleep apnea treatments, which affects 30 million Americans and can significantly increase a person's risk of cardiovascular disease , diabetes, cognitive impairment and fatigue if it is not treated. The current treatment is a continuous positive airway pressure (CPAP) machine, which is highly effective and delivers air directly to a patient through a bedside device while asleep.
Still, there is no ingestible medication available to remedy the effects of the disease, and most patients refrain from using CPAP devices overnight – if they do so – because of its disruptive design and the fact that that the treatment does not last all morning.
"The best they can get is an improvement of about 50 percent in their apnea," said co-author David W. Carley, PhD, in a statement from Northwestern University, which partnered with the University of Illinois at Chicago for the study. "When people take a pill to treat apnea, they are treated throughout the night."
People who choose to use the machine rarely stay with it for more than four hours a night, he said.
In Carley and colleagues study, 73 patients with severe sleep apnea were divided into three groups. One group was randomly badigned to a low dose of dronabinol, the second was badigned a higher dose and the third took a placebo pill. For six weeks, participants took the pill before bedtime.
The researchers found that after a month and a half, patients who had ingested the highest dose of dronabinol-10 milligrams-reported a lower frequency of apneas and hypopneas, subjective drowsiness decrease, and greater overall treatment satisfaction than the group placebo.
These results may be derived from a different approach to the treatment of apnea, Carley and her coauthors wrote; Instead of targeting the physical symptoms of the disease, the scientists treated patients with a medication that also focused on the brain.
"By providing a pathway towards the first obstructive sleep apnea drug viable, our studies could have a great impact on clinical practice," Carley said.