Sleep apnoea costs the UK and US economies more than £137bn a year, with researchers calling for workplace screening and earlier treatment.

The condition causes repeated pauses in breathing during sleep. People often snore loudly, wake gasping for air and experience severe daytime tiredness. If untreated, it raises the risk of heart attack and stroke.

Sleep apnoea is estimated to affect around one billion people worldwide, including about eight million in the UK, though up to 85 per cent of cases are thought to be undiagnosed.

The study was led by researchers at University College London, who surveyed more than 4,000 adults in the UK and US.

They found that around one in five respondents reported frequent breathing pauses during sleep alongside excessive daytime sleepiness, both key indicators of the condition.

The economic impact was assessed through lost working days and reduced productivity.

The researchers estimated that obstructive sleep apnoea costs the US economy US$180bn (£133bn) a year and the UK economy £4.2bn. They said this is likely to be an underestimate, as healthcare costs and the impact of road and workplace accidents were not included.

“Given the significant yet often overlooked burden of obstructive sleep apnoea and its economic impact, we urge policymakers to allocate resources towards developing an effective screening strategy and implementing targeted public health campaigns and policies,” the authors wrote.

“Early identification and treatment of obstructive sleep apnoea, along with proactive early follow-up, could result in substantial savings, potentially amounting to billions annually in productivity costs.”

Maintaining treatment can be difficult.

Nearly two-thirds of patients stop using continuous positive airway pressure therapy, the standard treatment that keeps airways open by delivering a steady flow of air through a mask during sleep.

Alternatives such as weight loss drugs, mouth guards and hypoglossal nerve stimulation implants are not suitable for all patients.

Researchers noted that newer low-cost diagnostic tools and screening algorithms could improve detection, but warned that some workers may fear negative consequences if they disclose the condition.

The trade union Unite, which represents many road haulage and passenger transport drivers, said it supports screening only if workers are properly protected.

Adrian Jones, national officer at Unite, said: “Professional drivers often hide issues of sleep apnoea out of fear of losing their jobs.

“Before introducing screening, employers must be fully educated that sleep apnoea can be effectively managed.

“Workers must have the confidence that they will be supported, not dismissed, if a problem is identified.”

Despite having its application for a new, daily Alzheimer’s pill rejected by Europe’s regulators the CEO of US drug company Anavex Life Sciences is appealing this decision.

A Phase IIb/III trial  found over one-third of patients with mild Alzheimer’s – those with a Mini-Mental State Examination (MMSE) score of between 20 and 28 – experienced a slowing of their ‘cognitive decline’.

And, for the majority of the population – those with the common sigma-1 gene – the results were even more dramatic, slowing decline by 49.8%.

Despite this success, in December last year, the European medical authorities rejected an application for the drug – known as Blarcamesine – saying the study ‘failed to demonstrate effectiveness and safety’.

Within days Anavex initiated a challenge to the decision. It has called for a re-examination of the evidence and this is now being undertaken by the European Medicines Agency (EMA).

Speaking to Agetech World Dr Christopher Missling, president and CEO of Anavex, said: “The trial data showed that patients actually improved their quality of life.

“The Alzheimer’s patients had a higher quality of life at the end of the trial than at baseline.”

What Is Blarcamesine?

Unlike other treatments targeting Alzheimer antagonists, such as amyloid-beta or tau pathology, Blarcamesine acts upstream by activating sigma-1 receptors.

This permits the restoration of autophagy – the intracellular recycling and cleaning system which is impaired in pathologies such as Alzheimer’s.

Alzheimer treatments such as Leqembi – which has been approved in over 50 counties and targets amyloid-beta plaques in the brain to slow Alzheimer progression – require regular hospital infusions and carry the risk of brain swelling and bleeding.

Blarcamesine is a pill, taken orally, with no evidence of damaging side effects, such as brain swelling or micro-bleeding, eliminating the need for frequent MRI monitoring required for other drugs.

Dr Missling said: “None of this would be required with Blarcamesine, which is a once-daily, simple oral pill you can ship anywhere.

“The efficacy is also extremely favourable; we see a double or more benefit of cognition and function compared to those injectable antibodies. So, it potentially offers a strong advantage not only in safety and convenience but also in efficacy.”

Why was it rejected by the EU?

A statement from the EMA outlined its position: “In December 2025, EMA’s human medicines committee, the Committee for Medicinal Products for Human Use (CHMP), concluded that the main study failed to demonstrate effectiveness and safety of Blarcamesine Anavex in patients with early Alzheimer’s disease who do not have a mutation in the sigma-1 gene.”

It went on to say that Anavex has requested a ‘re-examination of EMA’s opinion issued on December 11, 2025…(and) the agency will re-examine its opinion and issue a final recommendation’.

Concerns raised by the CHMP focused on trial methodology, possible side effects in the nervous system, and impurities that could potentially cause cancer.

Dr Missling highlighted how a lengthening of the titration process had addressed the mild-dizziness issue and the impurity concerns, which centred on an acceptable threshold for nitrosamines, has also been negated.

And, he highlighted how the amyloid-beta plaque-targeting drugs Leqembi and  Kisunla – which have been fully approved in the US – were eventually approved in Europe after a similar re-examination process .

USA application

Anavex has started a dialogue with the US Food and Drug Administration which has requested access to all of its trial data and if approved in the USA it will open-up the potential for global market authorisation.

The potential size of the market for Blarcamesine is huge, with the number of adults suffering from Alzheimer’s disease expected to grow from around 60 million to 150 million by 2050, as the global population ages.

Dr Missling on how Blarcamesine works

“Blarcamesine activates the Sigma-1 receptor in vivo, which has been confirmed in several peer-reviewed publications and established with a PET study demonstrating dose-dependent activation in the brain.

“The sigma-1 is an integral membrane protein involved in restoring cellular homeostasis. It activates an upstream compensatory process – autophagy – through sigma-1 activation.

“Autophagy gets impaired over time during aging and especially during pathologies like Alzheimer’s and Parkinson’s. This is a very important process, which is nothing else but the recycling of neurons who cannot get rid of their ‘trash’, if you like; they have to recycle it. If this mechanism is impaired, those cells eventually die.

“It stands at the top of many cascades of this complex pathology, for example, on top of A-beta aggregation or Tau aggregation.

“That’s why it’s intriguing to try to approach this from a more comprehensive upstream viewpoint.

Blarcamesine is a small molecule you can take once a day. It restores homeostasis, reactivates impaired autophagy, and lets the body function as it does in a healthy fashion.”

Apple Watch hypertension alerts may miss cases of high blood pressure, with the absence of an alert offering limited reassurance, particularly for older adults, researchers say.

Hypertension, or high blood pressure, occurs when blood consistently pushes too forcefully against artery walls, increasing the risk of heart disease and stroke.

The study applied performance data from the smartwatch’s blood pressure notification feature to US population statistics to estimate how it performs in real-world use.

Researchers found that around 69 per cent of people who received an alert did have hypertension, while about 79 per cent of those who did not receive an alert were free of the condition. Performance varied by age, race and ethnicity.

The feature, cleared by the US Food and Drug Administration last year, is not intended to diagnose hypertension. It uses an optical heart sensor to flag patterns that may suggest raised blood pressure. A validation study submitted to the regulator showed that roughly 41 per cent of people with undiagnosed hypertension received an alert, while nearly 59 per cent did not. Among people without hypertension, 7.7 per cent received an inappropriate alert.

The analysis was carried out by researchers at the University of Pennsylvania and the University of Utah.

In groups where undiagnosed hypertension is more common, alerts were more likely to reflect true hypertension, while the absence of an alert was less reassuring.

For adults aged 60 and older, receiving an alert increased the probability of having hypertension from 45 per cent to 81 per cent. However, those in this age group who did not receive an alert still had a 34 per cent probability of having undiagnosed hypertension.

Performance also differed by race and ethnicity, reflecting wider disparities in cardiovascular health linked to social factors. Among non-Hispanic Black adults, an alert increased the probability of hypertension from 36 per cent to 75 per cent, while the absence of an alert lowered it to 26 per cent.

Jordana Cohen, the study’s lead author and an associate professor of medicine and epidemiology at the University of Pennsylvania School of Medicine, wrote: “However, the absence of an alert provides limited reassurance, particularly in older and higher-risk adults, and routine blood pressure measurement with validated cuff-based devices remains essential.”

The researchers added that while the feature could help many people unaware they have hypertension, “an even larger proportion of individuals with undiagnosed hypertension could receive no alert at all.”

They cautioned that false reassurance may lead to missed opportunities for early detection and treatment, adding: “Rigorous validation, strategies to improve cuffless device accuracy, and thoughtful integration into population screening will be essential if cuffless technologies are to contribute meaningfully to hypertension detection.”