\n<\/p>\n
But the search for such a pill\u2014or indeed any treatment as effective as CPAP\u2014has proved challenging. Dozens of drugs have failed to show efficacy in clinical trials, and while HGNS was first approved by the US Food and Drug Administration in 2014, Miller says that its rollout has been limited, as many doctors are uncertain about the risk-to-benefit trade-off. \u201cThe device is quite costly, and the implantation requires a surgical procedure,\u201d he explains, which comes with added risk to the patient. \u201cAs with any new technology, there is often a lag in acceptance from both the medical community and insurers.\u201d<\/p>\n
It\u2019s unlikely that a single therapy will be found as an alternative to CPAP, Gaisl argues, because sleep apnea isn\u2019t one single disease\u2014rather, a diverse cluster of conditions. Obesity is known to be one of the major risk factors\u2014and the weight-loss drug tirzepatide has recently been licensed as a sleep apnea therapy\u2014because excess fat around the neck and upper body can obstruct the airway and cause pauses in breathing. But there are many other causes, some of which are only recently coming to light. Researchers are now beginning to understand the impact of ethnicity on sleep apnea, for example, with patients in Asia at heightened risk.<\/p>\n
Sleep apnea is resultant of \u201ca mosaic of different things, not just obesity,\u201d says Gaisl. \u201cWe\u2019re increasingly seeing that different subgroups benefit most from more personalized approaches.\u201d<\/p>\n
This recognition has led researchers to focus more on the EDS population. Gaisl estimates that simply having EDS is equivalent to increasing your BMI by 11 points in terms of the likelihood of developing sleep apnea. That\u2019s because the genes linked to EDS affect the structure of so-called \u201cmatrix proteins\u201d like collagen and elastin, which provide the framework for the body\u2019s connective tissues\u2014everything from skin to tendons, muscles, and ligaments.<\/p>\n
\u201cCollagen is an integral part of almost all tissues, including those which form the airway,\u201d says Karim Ghobrial-Sedky, an adjunct professor at Drexel University and a sleep specialist who has treated EDS patients with sleep apnea. \u201cIn EDS, it\u2019s this abnormality in collagen which makes the airway more prone to collapsing when the person is taking a breath.\u201d<\/p>\n
Because of this, researchers believe that EDS sleep apnea patients are especially suited to treatments targeting muscles in the tongue and throat\u2014like Miller\u2019s HGNS, or a newer drug combination under development by a company called Apnimed. Based on the discovery that two compounds, atomoxetine and aroxybutynin, could work in synergy to improve upper airway muscle tone and reduce airway muscle relaxation during sleep, Apnimed has been shown in a clinical trial to reduce instances of sleep apnea by 56 percent. \u201cPeople with hypermobility are a prime target cohort for these kinds of therapies,\u201d says Gaisl.<\/p>\n
While EDS was long considered rare, recent studies suggest genetic hypermobility may affect as many as 1 in 500 people, with women disproportionately affected. Gaisl believes the underlying biology behind these conditions also offers clues for explaining other subtypes of sleep apnea. In his view, the genetics of EDS actively mirrors the damage which other people are inadvertently inflicting on their matrix proteins through behaviors and environmental stresses like smoking, chronic inflammation, excessive dietary sugar and the aging process itself, heightening their risk of sleep apnea through midlife.<\/p>\n
\u201cEDS is a kind of natural experiment which is giving us insights into some of the key biological mechanisms behind sleep apnea that are masked in the general population,\u201d says Gaisl.<\/p>\n
Such individuals could benefit more from targeted therapies like HGNS or Apnimed\u2019s drug combination, compared with patients whose apnea is primarily driven by weight gain or underlying breathing abnormalities. Newer diagnostics are applying AI algorithms to patients\u2019 sleep data, pinpointing key patterns that suggest a specific type of airway collapse. In the future, these tools could help clinicians to identify such people both faster and more accurately, as well as individuals with undiagnosed hypermobility. These insights could then be used to tailor their treatment.<\/p>\n
As researchers learn more about the role of matrix proteins in EDS-related sleep apnea, it could even pave the way for entirely new treatments in future.<\/p>\n
Matrix proteins \u201creally point to the importance of collagen in maintaining the airway during sleep,\u201d says Gaisl. \u201cThis opens up a new avenue for therapeutics which perhaps target how the connective tissues are impacted over time, causing sleep apnea\u2014treatments which could ultimately benefit a much broader range of patients.\u201d<\/p>\n","protected":false},"excerpt":{"rendered":"
But the search for such a pill\u2014or indeed any treatment as effective as CPAP\u2014has proved challenging. Dozens of drugs have failed to show efficacy in clinical trials, and while HGNS was first approved by the US Food and Drug Administration in 2014, Miller says that its rollout has been limited, as many doctors are uncertain<\/p>\n","protected":false},"author":1,"featured_media":13069,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[52],"tags":[6766,6764,364,4025,6767,6765],"class_list":{"0":"post-13068","1":"post","2":"type-post","3":"status-publish","4":"format-standard","5":"has-post-thumbnail","7":"category-technology","8":"tag-apnea","9":"tag-hyperflexible","10":"tag-people","11":"tag-sleep","12":"tag-treatments","13":"tag-unlock"},"_links":{"self":[{"href":"https:\/\/naijaglobalnews.org\/index.php?rest_route=\/wp\/v2\/posts\/13068","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/naijaglobalnews.org\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/naijaglobalnews.org\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/naijaglobalnews.org\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/naijaglobalnews.org\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=13068"}],"version-history":[{"count":0,"href":"https:\/\/naijaglobalnews.org\/index.php?rest_route=\/wp\/v2\/posts\/13068\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/naijaglobalnews.org\/index.php?rest_route=\/wp\/v2\/media\/13069"}],"wp:attachment":[{"href":"https:\/\/naijaglobalnews.org\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=13068"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/naijaglobalnews.org\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=13068"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/naijaglobalnews.org\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=13068"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}