Inside Sleep with The Snoring Doctor Issue #5

Hello!

Happy New Year, everybody! 2023 was an exciting year for me. I’ve thoroughly enjoyed educating readers like you or those who follow me on social media about snoring and sleep apnea. It’s so important that sleep apnea enters mainstream conversations because millions of people are suffering from it without even knowing. 

This year, I’ll continue to push that message along as much as I can, and I hope you’ll do the same. If you do manage to convince your loved ones who snore to seek out a sleep study or treatment for their sleep apnea, tell me about it either here or on my social media! I love to hear stories about how sleep apnea treatment changes people’s lives for the better. 

In the first edition of Inside Sleep for 2024, we’ll talk about an interesting sleep apnea treatment undergoing clinical trials, and give some thoughts on the reported potential connection between drugs like Ozempic and sleep apnea.

Catching Up On Sleep: A Current Events Roundup

Apnimed’s OSA Pill Kicks Off Phase 3 of Their Clinical Trials

As a sleep apnea patient myself, I’m a dedicated CPAP user, but not every sleep apnea patient can say the same. About half of the patients prescribed a CPAP machine eventually stop using it due to discomfort, embarrassment, inconvenience, or other reasons. Unfortunately, that’s a big problem because untreated sleep apnea can be deadly. 

In this newsletter, I’ve talked about a lot of alternatives to CPAP, including surgical procedures, implantable devices, and oral appliances. Well, there’s another option currently undergoing clinical trials that could potentially change sleep apnea treatment forever if it’s proven effective.

Apnimed, Inc., a pharmaceutical company focused on oral pharmacologic therapies for OSA, has initiated the SynAIRgy Phase 3 study. This study aims to assess the efficacy and safety of AD109 (aroxybutynin/atomoxetine), a pill that hopes to be an alternative to CPAP for OSA patients.

The SynAIRgy study involves 640 participants with OSA who are intolerant of or refuse PAP therapy. It's a randomized, double-blind, placebo-controlled investigation, with the primary goal of demonstrating the safety and superiority of AD109 over a placebo in reducing airway obstructions.

The pill is administered once daily at bedtime and could potentially be effective across a range of OSA severity. AD109 targets neurological pathways relevant to OSA, activating upper airway dilator muscles to keep the airway open during sleep—similar to upper airway stimulators like the Inspire Implant. 

The potential impact of AD109 is substantial and alluring enough to receive a Fast Track designation from the FDA. That makes sense; picture a simple, once-daily pill that treats your sleep apnea instead of a bulky machine. Of course, despite all the excitement, we don’t yet know for certain that this pill will work or what side effects it may have. 

While we watch along to find out, don’t wait to start treating your sleep apnea! The sooner you start seeking treatment, the better for your health and longevity.

Can Ozempic Improve Sleep Apnea?

GLP-1 medications, such as Ozempic and Wegovy, have gained a lot of momentum in popular awareness. These drugs were designed to manage diabetes and obesity, and they’ve been noted for their impact on weight loss in particular. That weight loss piece is at the root of what we’ll talk about here. 

In the story linked above, you’ll read about a woman who lost 50 pounds as a result of taking Ozempic. She also claims that after the weight loss, she no longer had to use her CPAP machine. Of course, I’m not this woman’s doctor, so I can’t claim to know the particulars of her sleep apnea, but at face value, this claim is a bit worrisome to me. 

I’ve talked a lot about the connection between weight loss and sleep apnea. Many will tell you something similar to what you’ll read in that article: Losing weight can improve sleep apnea symptoms. The thinking is that the reduction in fat tissue around the neck and abdominal areas can directly impact airway obstruction, leading to enhanced breathing during sleep.

But the truth is more complex, though. It’s not as simple as “Fixing obesity will also fix sleep apnea.” OSA happens in all body types—it’s more often than not the result of aging tissue in the throat, tongue, or nasal airway. That’s why just dropping weight is very unlikely to cure your sleep apnea, as the article suggests.

While the weight-centric explanation is a bit dubious to me, there might be more to this story. GLP-1 drugs are known to affect the brain, prompting investigations into whether these medications have direct effects on sleep regulation beyond their impact on body weight. That may ultimately be more relevant to central sleep apnea, if anything.

I want to be extremely clear here, though, that GLP-1 medications are not approved for sleep apnea treatment, regardless of any anecdotal evidence. If clinical trials are ever conducted to dive into this relationship, I’ll definitely be interested in learning more. But until then, I highly encourage everyone with sleep apnea to build a treatment plan with their doctors.

Sleep Fact

It seems like in every couple, one person is the space heater, and one is the freezer. When the freezer starts piling blankets on the bed, that space heater is probably in for a sweaty night. But recent research from the University of Córdoba indicates that your space heater’s night sweats could be holding information about the severity of their sleep apnea. 

"By analyzing sweat metabolome and its alterations, mainly at night, we were able to see what stage of the disease the patients were in," the study's lead author explained. Now, not every person who’s sweating through their pajamas has sleep apnea, but for those who do have it, this finding could be pretty helpful for tracking the progression of their condition.

Sleep Clip of the Month

This one is less about a particular piece of sleep advice or information and more about showing some appreciation for everyone who’s engaged with my content so far. I’m so grateful to be able to share all of this essential information with you all, and I’m excited to keep going. Here’s to 2024—hopefully, a year of world-class nasal breathing and good sleep!

How to further connect with The Snoring Doctor:

If you’d like to hear the latest sleep news, you’re in the right place.

To join in on the conversation, you can follow me on LinkedIn and Instagram.

If you’re ready to get treatment for your snoring and sleep apnea, reach out here to request an appointment.

Sweet dreams and happy breathing,

Dr. Ben Cilento, “The Snoring Doctor”

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