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Exciting New Treatments Could Help Snorers (and their partners!)

snoringSevere snorers could soon have exciting new treatments at their fingertips thanks to breakthrough Australian research uncovering fresh triggers for obstructive sleep apnoea (OSA).

The study reveals three previously-unknown causes for the common disordered-breathing condition, paving the way for new targeted therapies to treat people who can’t or don’t want to use the current first line treatment, CPAP.

Obstructive sleep apnoea currently affects five per cent of Australians, with rates highest among the elderly and obese.

Lead author Dr Danny Eckert, a former Harvard researcher now at Neuroscience Research Australia (NeuRA), says “The landmark find could change the landscape of OSA treatment in the future, ensuring thousands more Australians get relief from the debilitating night time condition.

“We’ve unearthed brand new problem areas for OSA sufferers, suggesting that we might be able to treat these rather than focusing solely on the anatomical problem of a collapsing airway, as we have until now,” Dr Eckert says. “That’s a pretty exciting development that takes OSA treatment off in a totally new direction.”

The research team enlisted 75 people with and without the condition and made detailed physiological measurements over three nights in the sleep lab. Surprisingly, they found that one fifth of those without OSA had the same anatomical problem of a narrow collapsing upper airway as those with OSA. However, those with OSA also had one or more non-anatomical triggers that the others did not. “That tells us that anatomy is one factor but not the only one,” says Dr Eckert, research chair of the Australasian Sleep Association.

The three other issues identified as common among sufferers were: problems with muscle responsiveness in sleep; waking too easily, whereby the muscles aren’t forced to work to overcome the collapse; and poor respiratory control, essentially an overly-sensitive response to carbon dioxide that builds up while asleep.

“This tells us that people get OSA for different reasons, so by identifying these traits in individual patients we may be able to develop simple, personalised treatments for OSA,” the researcher says.

Excitingly, the results suggest that in the future over half of all sleep apnoea patients may be able to be treated with one or more non-CPAP therapies targeted at their specific traits.

Preliminary work is already underway in these areas, with researchers investigating how oxygen therapy and medication can stabilize carbon dioxide swings, or how muscles can be ‘trained’ to respond better during sleep. Dr Eckert’s own research considers how some sleeping pills may help improve OSA by aiding sleep, while others may make it worse.

Australasian Sleep Association president Nick Antic says the findings prove OSA is not just about anatomy, weight and age, as had been thought.

“Here we have an important discovery that this condition is far more complex than first thought,” Associate Professor Antic says. “Armed with this knowledge, we’ll hopefully be able to give everyone with OSA an opportunity to get some relief from it.”

The paper is published in the world’s leading respiratory and sleep journal, American Journal of Respiratory and Critical Care Medicine.

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Alana Lowes

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