Obstructive Sleep Apnea
A Major Public Health Problem
The most common current treatment approach for Obstructive Sleep Apnea (OSA) relies on positive pressure devices, especially CPAP, to maintain an open airway. At Apnimed, we are advancing a pipeline of oral medications that address the disease’s underlying neurobiology to activate upper airway muscles and maintain an open airway during sleep. If successful, this approach will constitute a major advance for patients with OSA.
Sleep apnea affects more than 25 million Americans and has serious consequences.
The National Commission on Sleep Disorders Research has identified sleep disorders as a major public health burden affecting millions of North Americans. OSA is one of the most common and serious of these sleep disorders and affects approximately 6% of women and 13% of men, which means that more than 25 million Americans are affected and hundreds of millions more are also affected around the globe.
OSA is characterized by partial or complete upper airway obstruction during sleep. This occurs when the muscles that support the soft tissues in the throat, such as the tongue and soft palate, temporarily relax. When these muscles relax, the airway is narrowed or completely closed, and breathing is momentarily cut off, resulting in hypoxemia – below-normal level of oxygen in the blood. OSA can result in arousal or broken sleep, loud snoring, daytime sleepiness or fatigue, and, long-term, can result in cardiac and metabolic morbidity and mortality.
OSA is caused by a combination of predisposing anatomical factors and a reduction in sleep-related neuromuscular control of the upper airway muscles.
Limited Treatment Options, Low Compliance
OSA is a chronic disease and therefore requires long-term management. The goals of OSA treatment are to reduce the Apnea-Hypopnea Index (AHI), which is the number of full or partial airway closures that occur each hour of sleep, improve oxygen levels and symptoms.
Sleep-related muscular relaxation driven by the central nervous system is the key neurologic issue leading to OSA. In patients with OSA, sleep onset leads to a reduction in neuromuscular control of the upper airway and a corresponding relaxation of the upper airway and tongue muscles. The vast majority of diagnosed patients are prescribed positive air pressure therapy devices such as continuous positive airway pressure, or CPAP, but fewer than half are compliant long-term, leaving a significant population untreated, undertreated and at risk.
A few oral medications are under development or have been approved addressing the symptoms of OSA, such as excessive daytime sleepiness, but these treatment options do not address the underlying biology of the disease. As a result, patients may still be at risk for the serious and potentially life-threatening consequences of OSA.
Fewer than half of patients prescribed CPAP therapy are compliant.
Some patients may have symptomatic snoring but don’t necessarily meet the criteria for OSA diagnosis. Symptomatic snoring is characterized by loud and persistent snoring, partial airway obstruction, as well as sleep disruption, and impacts both the snorer and their bed partner. Apnimed is developing therapies for this patient population as well.