Small study suggests nasal spray could help sleep apnoea

Relief could be on the horizon for the estimated 20% of Australians experiencing obstructive sleep apnoea (OSA), with researchers discovering a nighttime nasal spray may be able to reduce the condition’s severity.
 
The Flinders University-led research, recently published in the Journal of Heart and Circulatory Physiology, investigated how topical application of a novel potassium channel antagonist nasal spray could impact pharyngeal muscle activation and upper-airway collapsibility.
 
The spray, BAY2586116, was found to be well-tolerated with no reported serious drug-related adverse effects and produced hours of ‘sustained improvement’ in upper-airway collapsibility.
 
Additionally, participants reported no changes in sleep quality or next day function.
 
Continuous positive airway pressure (CPAP) machines are the most proven treatment for the sleep disorder, but in addition to the associated costs of the machines, the majority of users struggle to tolerate them. The Australasian Sleep Association’s Sleep Health Primary Care Resources notes the effectiveness of CPAP treatment is ‘limited by variable adherence’.
 
As such, GP and sleep health expert, Bond University Professor Nick Zwar, told newsGP while the nasal spray needs much more testing before it becomes clinically available, it could be important for many people should further research validate the recent findings.
 
‘This is a long way from becoming a treatment option, [it] needs a lot more research,’ he said.
 
‘The main current treatment for OSA – CPAP – is burdensome for patients, and the CPAP machine is expensive, so other options that are easier for people to use would be welcome.’
 
The study included just 10 participants, of whom seven responded to the potassium channel blocker nasal spray by showing a reduction in the frequency of upper-airway collapsing episodes during sleep. The nighttime nasal spray also showed potential in lowering blood pressure of people with OSA.
 
Study participants were given either the BAY2586116 nasal spray, a placebo, or the nasal spray in combination with restricted ‘nasal only’ breathing. Use of the latter did not improve quality of sleep in the trial.
 
‘What we have discovered is that the nasal spray application of the potassium channel blocker that we tested is safe, well tolerated,’ lead author from Flinders Health and Medical Research Institute Sleep Health, Dr Amal Osman, said.
 
‘Those who had a physiological improvement in their airway function during sleep also had between 25–45% reductions in markers of their OSA severity including improved oxygen levels as well as a reduction in their blood pressure the next day.’
 
BAY2586116 is part of a class of drugs that block the potassium channel in the central nervous system, and have the potential to increase the activity of the muscles that keep the upper airway open and reduce the likelihood of the throat collapsing during sleep, the paper explains.
 
And while its authors concluded that the ‘small but physiologically comprehensive’ findings require further investigation in a larger ‘appropriately designed’ study, co-author Professor Danny Eckart said they nonetheless demonstrate promise.
 
‘Right now, there are no approved drugs for treating OSA, but through these findings and future research we are getting closer to developing new and effective drugs that are safe and easy to use,’ he said.
 
‘These insights provide a potential pathway for development of new therapeutic solutions for those people with OSA who are unable to tolerate CPAP machines and/or upper airway surgery, and those with a desire for alternatives to existing therapies.’
 
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