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Oxytocin for Sleep Apnea

This recently published patent application covers the use of oxytocin to treat sleep apnea, that condition in which a person's snoring is so bad that breathing stops completely for anywhere from a couple seconds to half a minute.

The inventor, Dr. Jeffrey D. Gould, is head of Neurology and Sleep Medicine, P.C. in Bethlehem, Penn.

For an official diagnosis of obstructive sleep apnea (OSA), pauses in breathing must last at least 10 seconds and happen at least five times per hour.

OSA is linked with increased risks of stroke, myocardial infarction, uncontrollable hypertension and obesity. There's some evidence that it's linked with an increased risk of Alzheimer's disease. And it can make a person dangerously sleepy, or, at best, unproductive.

According to Dr. Gould's application, this disorder affects 4 percent of men and 2 percent of women. Common treatments include removing some of the low-hanging tissue at the back of the throat or providing a mask that increases air pressure. But these don’t always work. Over-the-counter remedies include inhalers, antihistamines and those funny little pieces of tape that are supposed to hold the nostrils wider apart.

According to his patent application,

Muscles in the throat are two types, skeletal and smooth. … Skeletal muscle is under direct mental control allowing for functions such a phonation and voluntary swallowing. REM sleep is an example of complete atonia of the skeletal muscle. Smooth muscle also has a tone reduction in sleep which worsens in REM sleep. Of note is that this stage of sleep is typically when OSA is at its worst. If muscarinic receptors can be stimulated on smooth muscle receptors in the throat during sleep, the muscles would remain contracted. These contracted muscles would keep the airway forced open, remediating apnea, which is caused by recurrent throat closure.

Oxytocin is known to interact with the smooth muscle of the uterus. Specifically, it binds to muscarinic receptors which produce contraction of uterine muscle. The muscarinic smooth muscle receptors of the uterus are the same as in other body organs including the throat.

Therefore, oxytocin might keep the throat from relaxing quite so much, which in turn would keep those floppy places from flopping so low they cut off all the air.

Gould's best dose and delivery method for treating an adult with OSA is 10 units (for a 70 kg. person) intramuscularly at the time of sleep. However, few people would be willing to give themselves a nice little injection at bedtime. The injection doesn’t have to be in the throat ... but still.

He's found that suppositories, nasal sprays and tablets work if they're in extended release form with a delivery rate of 10 units delivered over a seven-hour period.

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