A medication called sulthiame significantly reduced breathing interruptions in people with moderate to severe sleep apnea, cutting pauses by up to 47% compared to placebo. The findings from a European clinical trial suggest that a pill-based treatment could finally offer relief to the millions of people who find continuous positive airway pressure (CPAP) masks uncomfortable or impractical .

What Is Sleep Apnea and Why Is Treatment So Challenging?

Obstructive sleep apnea occurs when the upper airway repeatedly collapses during sleep, causing breathing to stop temporarily and reducing oxygen levels in the blood. These episodes disrupt sleep throughout the night, leaving people exhausted the next day. Over time, untreated sleep apnea raises the risk of serious health problems, including high blood pressure, cardiovascular disease, stroke, and type 2 diabetes .

The current gold standard treatment is CPAP therapy, which uses a mask worn during sleep to keep the airway open. While CPAP is highly effective, it has a major drawback: up to half of patients stop using the device within a year because the mask feels uncomfortable or interferes with sleep quality . This treatment gap has left researchers searching for alternatives that patients will actually stick with.

How Does Sulthiame Work to Improve Sleep Apnea?

Sulthiame is an existing medication that has previously been approved to treat a form of childhood epilepsy. Researchers are now investigating whether it could also become a drug treatment for sleep apnea by working on the brain's control of breathing .

The drug appears to work by stabilizing the body's control of breathing and increasing respiratory drive. This helps lower the likelihood that the upper airway will collapse during sleep, which is the main cause of obstructive sleep apnea. Rather than mechanically holding the airway open like CPAP does, sulthiame addresses the underlying problem at the source .

What Did the Clinical Trial Show?

The study was a rigorous European clinical trial involving 298 people with moderate to severe sleep apnea across four countries. The trial used a double-blind design, meaning neither the participants nor the researchers knew who was receiving the active drug and who was receiving a placebo. This design helps eliminate bias and ensures the results are reliable .

Patients who received higher doses of sulthiame experienced up to 47 percent fewer breathing interruptions during sleep compared with those given a placebo. They also showed improved oxygen levels overnight, a critical measure of how well the treatment was working . Most side effects reported during the trial were mild and temporary, suggesting the drug was well tolerated .

Steps to Understanding This Breakthrough for Sleep Apnea Treatment

• The Problem: Current CPAP therapy is effective but has poor long-term adherence, with up to 50% of patients abandoning the treatment within one year due to discomfort or sleep disruption.
• The Solution: Sulthiame, an existing epilepsy medication, stabilizes breathing control in the brain and increases respiratory drive to prevent airway collapse during sleep.
• The Evidence: A 298-person European clinical trial found that higher doses of sulthiame reduced breathing pauses by up to 47% and improved nighttime oxygen levels compared to placebo.
• The Safety Profile: Most side effects reported during the trial were mild and temporary, suggesting the medication is generally well tolerated by patients.

What Comes Next for This Sleep Apnea Treatment?

While the results are encouraging, researchers emphasize that more work is needed before sulthiame becomes widely available as a sleep apnea treatment. Jan Hedner, senior professor of pulmonary medicine at the Sahlgrenska Academy at the University of Gothenburg, led the research effort and reflected on the significance of the findings.

"We have been working on this treatment strategy for a long time, and the results show that sleep apnea can indeed be influenced pharmacologically. It feels like a breakthrough, and we now look forward to larger and longer studies to determine whether the effect is sustained over time and whether the treatment is safe for broader patient groups," said Jan Hedner.

Jan Hedner, Senior Professor of Pulmonary Medicine, Sahlgrenska Academy, University of Gothenburg

The next phase will involve larger clinical trials to confirm that the benefits last over extended periods and to ensure the medication is safe for diverse patient populations. Researchers also need to determine the optimal dosing and identify which patients are most likely to benefit from the treatment .

For the estimated 30 million Americans with sleep apnea, many of whom struggle with CPAP compliance, the prospect of a pill-based alternative represents genuine hope. If sulthiame proves effective and safe in larger trials, it could transform treatment options for people who have struggled to find a solution that works for their lifestyle and comfort level.