New Sleep Apnea Treatment Could Be a “Game-changer”

Millions of people worldwide have been diagnosed with sleep apnea and they all have one thing in common: They all really hate their CPAP machines.

But a new drug treatment may be on the horizon that could offer a real alternative to the effective but burdensome CPAP.

The new treatment is being developed in Australia by a company called Snoretox Pty Ltd. in partnership with RMIT University in Melbourne. The technology would use molecules of tetanus toxin to restore muscle tone to the tissue around the upper airway. It would work in a very similar way to Botox which uses botulinum toxin to relax muscles. It won’t be on the market right away, but if all goes well, it could be available by the middle of the decade.

The frequent interruptions of breathing that occur in obstructive sleep apnea happen because the airway collapses in on itself when the sleeper tries to take a breath in. A prime cause for this is flabby tissue around the upper airway that’s too weak to hold things open as the muscles relax during sleep.

The main treatment for sleep apnea today is of course the CPAP machine. (Notice that second letter there is a P and not an R.) CPAP (pronounced “SEE-PAP”) stands for Continuous Positive Airway Pressure. It works by delivering constant air pressure through a mask into your airway to keep it from collapsing. It works well – in fact, these machines have saved a lot of people from a lot of misery. But they are cumbersome to use, and the masks are not always comfortable to wear. They’re also difficult to keep clean and an extra thing to pack when you travel.

Some sleep apneas can be treated with throat surgery to widen the airway. These procedures range from tonsillectomies and removal of the uvula to more radical operations to move the base of the tongue or the jawbone forward. But this is pretty invasive stuff, involving a certain amount of pain and recovery time, and the results aren’t always a sure thing.

A New Approach to Apnea

If Snoretox makes it to the market, it would be the first therapeutic drug treatment for sleep apnea. Its creators envision the drug replacing CPAP and surgery for most cases.

“Our modified tetanus toxin molecules offer real and effective treatment choices for patients,” says Snoretox founder Adjunct Professor Anthony Sasse, “and we anticipate the vast majority would love to get rid of their CPAPs.”

Snoretox was introduced at the BIO Digital International Convention early last June. Its development started about 15 years ago, headed by biotechnologist Professor Peter Smooker, at the RMIT School of Science.

Based on lab and pre-clinical trials, the company is optimistic that the drug will prove to be safe and effective in humans. Snoretox works by increasing the resting tone of muscles by partially blocking “the off signal” coming from the nerve. Its effect is designed to be completely localized to the targeted area without spreading in the central nervous system. Snoretox says the drug can be delivered in very low doses which gives it a big safety factor.

Since just about everyone has been inoculated against tetanus, a key challenge was to modify the toxin in such a way that it could still be effective in someone who’s been vaccinated.

The company thinks that the drug’s effect would last about 4 to 6 months at a time, so patients would be looking at 2 or 3 injection treatments per year at a cost that could compare favorably to the yearly cost of CPAP.

Other Uses for Snoretox

As the name Snoretox implies, the drug could also be used to treat chronic snoring that doesn’t necessarily involve sleep apnea. Loud snoring often arises out of the same conditions as sleep apnea and is sometimes a precursor to it.

The drug’s creators in fact see the therapeutic as a useful treatment for a multitude of conditions that stem from low muscle tone – the company has trademarked the drug as Snoretox for snoring and sleep apnea, and Tonetox for additional uses

The drug could be an especially effective treatment for incontinence by increasing muscle tone in the sphincter and pelvic floor. Tonetox could also help sufferers of a medical condition called ectropion which causes the lower eyelid to droop away from the eye. It could even help reduce the symptoms of diseases like muscular dystrophy, multiple sclerosis, myopathy and motor neuron disease. And like Botox, you could expect the drug to find its way into cosmetic uses as well.

The very first patients to receive Snoretox will likely be of the four-legged variety. Many dogs suffer from sleep apnea or disordered breathing problems, particularly the short-nosed breeds such as the English bulldog. The drug could also help horses with laryngeal hemiplegia, a common disorder that causes them to make a “roaring” sound as they breathe. Incontinence also affects many elderly pets and presents a difficult problem for their owners.

The next step for the company is to get regulatory approval for clinical trials. After that, we could hope to see Snoretox and Tonetox on the market within five years or so.

“With further development”, says Professor Sasse, “this brand new class of therapeutics will offer a game-changing alternative to the millions of people suffering low tone muscle conditions around the globe.”