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October 15, 2025
A decades-old drug used to treat childhood epilepsy could soon become the world’s first widely available medication specifically targeting sleep apnea, potentially transforming care for millions living with the condition. Researchers have found that sulthiame, an anticonvulsant first approved in the mid-20th century, shows promising effectiveness in reducing the number of nightly breathing interruptions associated with obstructive sleep apnea (OSA).
What the Study Found
Sleep apnea affects roughly one billion adults worldwide, causing repeated pauses in breathing during sleep that can lead to fatigue, cardiovascular disease, diabetes, and cognitive decline. Until now, treatment has depended on mechanical devices such as continuous positive airway pressure (CPAP) machines, oral appliances, or surgery—approaches that many patients struggle to tolerate long-term.
The new trial, led by researchers at the University of Gothenburg, repurposed sulthiame to test its ability to reduce airway obstructions during sleep. Preliminary results indicate that the drug significantly lowered apnea-hypopnea index (AHI) scores—an established measure of breathing disruptions—compared to placebo groups. Participants taking sulthiame reported deeper, less fragmented sleep without major adverse effects.
Although specific figures have not yet been made public, investigators described the degree of improvement as “clinically meaningful” and comparable to some mechanical interventions. These encouraging results could mark a shift toward pharmacological treatments for OSA—a category that, until recently, had no approved drug options.
A New Era of Drug-Based Treatment
The sulthiame findings build on growing global momentum toward pharmaceutical approaches for sleep apnea. In December 2024, the U.S. Food and Drug Administration approved Zepbound (tirzepatide), originally a weight-loss and diabetes drug, as the first prescription treatment for moderate to severe OSA in people with obesity. Studies in the New England Journal of Medicine found that Zepbound users experienced an average reduction of 25 to 29 apnea events per hour, alongside 18–20% body weight loss—outcomes that substantially exceeded placebo results.
Meanwhile, other GLP-1 receptor agonists—including Mounjaro (another brand of tirzepatide)—have shown up to a 60% reduction in apnea severity in clinical trials involving obese adults. These therapies work indirectly by promoting weight loss and improving airway mechanics, whereas sulthiame appears to act more directly on the central nervous system, influencing breathing rhythm regulation.
“Sulthiame’s mechanism targets the brain pathways that control breathing rather than weight-loss mechanisms,” explained Dr. Karin Larsson, the study’s senior author, in a press briefing. “This distinction is crucial because it may help patients who suffer from sleep apnea without being overweight or obese.”
Expert Reactions and Clinical Context
Experts unaffiliated with the study have greeted the findings with cautious optimism.
Dr. Michael Hensley, a pulmonologist at Duke University Medical Center, noted that “while the repurposing of sulthiame could fill a major gap for patients who can’t tolerate CPAP, large-scale, long-term trials are essential to understand its safety and effectiveness over time.”
Previous attempts to develop drug treatments for sleep apnea have been hindered by the condition’s complex origins—ranging from anatomical restrictions to neuromuscular and metabolic factors. Recent advances in pharmacology, however, have rekindled hope that multi-target approaches might finally deliver durable benefits.
A related review in Sleep Medicine Reviews (October 2025) suggested that drug combinations targeting both airway obstruction and cellular aging mechanisms—so-called senolytic therapies—could further improve cardiometabolic outcomes in OSA patients.
Why This Matters
Obstructive sleep apnea affects an estimated 15–30% of middle-aged adults and often remains undiagnosed. Left untreated, it significantly increases the risk of heart attack, stroke, hypertension, and insulin resistance. Researchers estimate that treating OSA could reduce cardiovascular mortality by as much as 25% in certain populations.
Current mechanical treatments, while effective, are not universally adopted. Studies show that as many as half of all patients abandon CPAP therapy within a year due to discomfort or difficulty maintaining compliance. As a result, a safe, oral medication could dramatically expand treatment access and adherence rates.
“Pharmacologic therapies could make sleep apnea treatment as routine as taking a daily antihypertensive,” said Dr. Samuel Ortiz, a sleep medicine specialist at Mount Sinai Health System. “That would be a paradigm shift for millions who currently lack tolerable long-term options.”
Limitations and Next Steps
Despite the encouraging results, sulthiame’s use in sleep apnea remains experimental. Researchers caution that its effects have so far been demonstrated only in small cohorts, and the precise neural mechanisms regulating airway stability are still under investigation. Additionally, potential side effects—such as dizziness, tingling, or fatigue—will need close monitoring if the drug progresses to Phase III trials.
The University of Gothenburg team is now seeking regulatory approval to launch a multi-center international study involving over 1,000 patients, which could begin in early 2026. If successful, sulthiame might join Zepbound and Mounjaro as the first generation of drugs for a condition once considered untreatable by medication.
Implications for Patients and Clinicians
For patients, particularly those intolerant of CPAP or ineligible for surgery, a medication-based therapy could offer convenience and improved adherence. Health professionals caution, however, that pharmacologic approaches should complement—not replace—lifestyle interventions and traditional therapies. Weight management, regular exercise, and avoidance of alcohol or sedatives remain central to managing OSA effectively.
Sleep medicine experts stress the importance of individualization. “No single therapy is likely to work for all patients,” said Dr. Hensley. “But the emergence of options like sulthiame and tirzepatide means we’re finally moving toward personalized treatment strategies that consider metabolic, anatomical, and neurological factors simultaneously.”
Medical Disclaimer:
This article is for informational purposes only and should not be considered medical advice. Always consult with qualified healthcare professionals before making any health-related decisions or changes to your treatment plan. The information presented here is based on current research and expert opinions, which may evolve as new evidence emerges.
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