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Mind & Body · Monday, 14 September 2026

01 Briefing what happened

In sleep apnoea the throat muscles go slack and the airway shuts, and the mask that holds it open works only for the hours it is worn

Mind & Body 52 sources

A mask that pushes air into the throat stops almost every blocked breath, but people wear it for about half the night, so pills and a weight-loss injection are now being tested on those who take it off.

4.5 hours

of CPAP use a night, on average, across 136 trials

up to half of patients give CPAP up within a year [3]

44.1% vs 17.6%

fall in blocked breaths on the AD109 pill, against a dummy pill, over 26 weeks

tiredness did not improve, and side effects made 21.2% quit [5]

about 20%

of body weight lost in a year on weekly tirzepatide in its sleep apnoea trials

CPAP was switched off for a week before each test, so the drug was never compared with the mask [7]

The lead story — what happened

  • In obstructive sleep apnoea the upper airway narrows or shuts again and again during sleep. Each blockage usually lasts about 30 seconds and ends with a drop in oxygen, a brief waking, or both. [1]
  • The collapse comes from the throat muscles losing their tone in sleep, and from the shape of the airway itself. [2] About 70% of people with apnoea also wake too easily, have weak muscle responses, or have breathing control that overreacts. [1]
  • Repeated blocked breaths set off the body's alarm system, which raises blood pressure and makes the heart work harder. [2] About 1 billion adults worldwide are estimated to have apnoea. [1] Across seven studies of 594 men, more blocked breaths an hour went with worse erectile function. [11]
  • Extra body weight accounts for an estimated 40% to 60% of cases, partly through fat inside the throat and neck. [7] In 538 people who declined treatment, apnoea usually got worse over about four years, and faster in those who were heavier or gained weight. [10]
  • The standard treatment is CPAP, a machine whose pump pushes air through tubing and a mask to hold the throat open. [2] Across 136 trials with 8,827 patients, people used it for 4.5 hours a night on average. [4]
  • Only 7.8% of those trials reached six hours of use a night. [4] Up to half of patients stop using CPAP within the first year. [3] The reasons people give include sore marks from the mask, air leaks that dry the eyes, and feeling closed in. [2]
  • A mouth guard that pushes the lower jaw forward stops fewer blocked breaths than CPAP. It can do about as much for sleepiness and blood pressure, probably because people wear it more. [3]
  • The largest trial of CPAP against heart attacks and strokes, called SAVE, found no benefit on average. [9] Its 2,687 patients were re-analysed in 2026 with a computer model, which suggested the mask may help some people and harm others. [9]
  • A new pill, AD109, pairs two drugs. Atomoxetine helps switch on the nerves to the throat muscles in sleep, and aroxybutynin blocks a signal that slackens those muscles in dream sleep. [3][2]
  • In a 26-week trial across 69 centres, 646 people who could not or would not use CPAP took AD109 or a dummy pill. Blocked breaths fell by 44.1% on the pill and by 17.6% on the dummy. [5]
  • Tiredness did not improve more on AD109 than on the dummy pill. [5] Across 13 trials of atomoxetine combinations, dry mouth hit 29.2% of people, against 9.5% on dummy pills. [6]
  • In the US, the weekly weight-loss injection tirzepatide is the only drug approved to treat the blocked airway itself, and only in adults with obesity. [3][7] In its trials, the fall in the top blood pressure number was tied to weight loss, and not to fewer blocked breaths on their own. [8]

Who is involved

  • Apnimed

    the drug company developing the AD109 pill; it funded the 646-person trial

  • The US Food and Drug Administration

    the US drug regulator; it approved tirzepatide for moderate-to-severe apnoea in adults with obesity, a group of about 10% of US adults

  • The SAVE trial

    the largest trial of CPAP against heart disease, 2,687 people; its data were re-run through a computer model this year

How it unfolded

  1. 1981 CPAP is introduced as a treatment for sleep apnoea [4]
  2. Jan 2026 a re-analysis of tirzepatide's sleep apnoea trials is published [8]
  3. Mar 2026 a computer re-analysis of the SAVE heart trial is published [9]
  4. Jul 2026 the 646-person trial of the AD109 pill is published [5]

Where this points

AD109 is still an experimental drug that needs a regulator's approval, so the next test is whether people keep taking a nightly pill that one in five quit over side effects. [3][5]

What is pushing on the whole day

The bar and the word are our reading of how hard each one is pushing today. The arrow is where it is heading. The evidence is in the stories below.

People stopping treatment High

Up to half of people given a CPAP mask stop using it within a year. [3] In trials of therapy for obsessive-compulsive disorder, more people dropped out of self-help done alone than out of guided therapy. [36] In the US, as few as 2% of people diagnosed with that disorder get the recommended therapy. [34]

Antibiotics losing their power High

Resistance in children's infections rose in every region of the world between 2004 and 2022. [18] The World Health Organization found one lab-confirmed bacterial infection in six resisted antibiotics in 2023. [19] National plans against resistance showed an effect only about five years after countries adopted them. [20]

Young people and nicotine Building

Current vaping among 11 to 17 year olds in Great Britain more than doubled between 2021 and 2025. [45] A US study found young adults who both smoked and vaped had higher odds of early lung cancer than those who only smoked. [44] A 15-year-old in Hull, England, was treated for air pockets inside the body after heavy vaping and cannabis use. [46]

Big findings under doubt Building

Scientists say several studies reporting plastic in human brains and arteries may have measured contamination. [39] A German trial of psilocybin for depression missed its main target. [27] A Swedish psilocybin trial found its effect had faded by one year. [28]

New treatments approved Building

The US approved a daily pill for advanced pancreatic cancer that nearly doubled survival in its trial. [13] It also approved the first drug aimed at muscle loss in spinal muscular atrophy. [14] Lab-grown insulin-making cells freed 10 of 12 people with type 1 diabetes from insulin in an early trial. [15]

The rest of the day

34 more stories on this beat.

Each with its own sources. None of these is a link to the story above.

  1. 02

    A pill for pancreatic cancer nearly doubled survival

    The US Food and Drug Administration approved daraxonrasib, sold as Rasonque by Revolution Medicines, on 26 August for advanced pancreatic cancer. [12] It shuts off a faulty gene called KRAS, which drives growth in more than 90% of pancreatic tumours. [13] In a 500-patient trial, people taking the daily pill lived a median 13.2 months, against 6.7 months on chemotherapy. [13] Severe side effects hit 44% on the pill and 57.5% on chemotherapy, and the agency approved it six months ahead of its deadline. [13]

    Why it matters — Pancreatic cancer has the highest death rate of the major cancers, and more than half of patients die within three months of diagnosis. [13] It is the first approved drug to attack a genetic cause of the disease. [12]

  2. 03

    First drug aimed at the muscle loss in SMA

    On 11 September the US Food and Drug Administration approved Isembyld, made by Scholar Rock, for spinal muscular atrophy, a rare disease of the nerves that control movement. [14] Existing treatments target SMN2, a gene those nerves depend on. [14] Isembyld is approved for adults and children aged two and over who already take one of them. [14] In the late-stage trial, young patients' movement skills improved over a year, while those on a dummy drug declined. [14]

    Why it matters — It is the first approved therapy aimed at the loss of muscle in the disease. [14] The company says decades of attempts to block myostatin, a protein that limits muscle growth, had failed before this one. [14]

  3. 04

    Lab-grown insulin cells let 10 of 12 stop injections

    In type 1 diabetes the body's immune system destroys the cells that make insulin. [16] A 2026 review reports that zimislecel, made by Vertex from stem cells, let 10 of 12 people in an early trial stop injecting insulin. [15] Those patients had suffered dangerous drops in blood sugar. [15] In the larger FORWARD trial, every participant spent more than 70% of the time with blood sugar in the target range after one infusion. [16] They also had to take drugs that suppress the immune system. [16]

    Why it matters — Donor pancreases are scarce and vary in quality, and cells grown in a lab could be made to a standard. [15] The need for immune-suppressing drugs is what still limits who can have them. [15]

  4. 05

    Donor islet transplants wear off

    Islets are the clusters of cells in the pancreas that make insulin, and they can be taken from a donor and infused into a patient's liver. [17] A 2026 review reports that in one study of 36 recipients across nine centres, 58% became free of insulin injections. [17] By two years, 76% of them were back on insulin. [17] The review says the cells die off from lack of oxygen, and patients need lifelong immune-suppressing drugs. [17]

    Why it matters — Researchers are developing coatings that shield transplanted cells from the immune system, to get around both problems. [17]

  5. 06

    Children's infections resist antibiotics in every region

    Researchers at the Murdoch Children's Research Institute in Australia analysed 106,581 infection samples from children in 82 countries. [18] Resistance to antibiotics rose in every region between 2004 and 2022. [18] Babies and children in intensive care, and children in poorer countries, were hit hardest. [18] The team projects resistance to last-resort antibiotics will reach 82% for the bacterium Acinetobacter baumannii and 35% for Klebsiella by 2035. [18]

    Why it matters — Children get many bacterial infections and have fewer antibiotic options than adults, with few medicines made in child-friendly forms. [18] The researchers found resistance even in simple urine infections, not only in severe illness. [18]

  6. 07

    One infection in six resisted antibiotics in 2023

    The World Health Organization gathered records of more than 23 million bacterial infections from 104 countries. [19] It found one lab-confirmed infection in six was resistant to antibiotics in 2023. [19] More than 40% of the antibiotics tracked lost strength against common blood, gut, urine and sexually transmitted infections between 2018 and 2023. [19] The rate was one in three in south-east Asia and the eastern Mediterranean. [19]

    Why it matters — In 2021, drug resistance played a part in 4.71 million deaths and directly caused 1.14 million. [19] The head of its resistance department said treatment options are running out, especially where infection control is weak and lab tests are hard to get. [19]

  7. 08

    Plans against resistance took five years to show

    A study in the journal Nature Medicine scored how 193 countries governed antibiotic resistance from 2017 to 2022, using 269 policy documents. [20] The average score rose from 30.7 to 44.5 out of 100. [20] Carrying the plans out, and checking on them, lagged behind writing them, especially for animals and the environment. [20] A measurable change in resistance appeared only about five years after a country adopted its plan. [20]

    Why it matters — The global action plan on resistance is being updated in 2026. [20] The study found that working across health, farming and animal sectors, and tracking antibiotic use, were most linked to better results. [20]

  8. 09

    PSA blood tests likely cut prostate cancer deaths

    Cochrane, an international group that reviews medical evidence, published a review in May of six trials with 800,000 men in Europe and North America. [21] It found PSA blood testing likely prevents about two prostate cancer deaths for every 1,000 men screened. [21] Its 2013 review had found no such benefit, and PSA testing fell out of favour after it. [21] The new review had up to 23 years of follow-up. [21]

    Why it matters — The benefit is small, and the test also finds slow cancers that would never have caused harm, whose treatment can cause infections and impotence. [21] The authors said the finding is not a blanket case for screening every man. [21]

  9. 10

    COVID vaccine linked to fewer heart events in veterans

    US researchers followed 1,039,659 veterans who got a flu vaccine in late 2024, of whom 349,085 also got that season's COVID vaccine. [23] Over eight months, the COVID vaccine was linked to a 37.7% lower risk of heart attacks, strokes and heart deaths tied to COVID. [23] The benefit was clear only in people over 75. [23] The vaccinated also had about 24% fewer heart events of any kind. [22]

    Why it matters — The lead researcher thinks many of those extra heart events came from COVID infections nobody tested for. [22] The study used health records rather than assigning vaccines by chance, so it shows a link. [23]

  10. 11

    28 million French adults followed for four years

    France's national health data covered 22.8 million adults aged 18 to 59 who got an mRNA COVID vaccine in 2021, and 5.9 million who did not. [24] Over about 45 months, the vaccinated had a 25% lower risk of dying from any cause. [24] Their risk of death from severe COVID was 74% lower. [24] The study found no increase in deaths from any cause in the vaccinated over four years. [24]

    Why it matters — No earlier study had compared long-term deaths by vaccination in young adults, who are less likely to get severely ill. [24] It is a cohort study weighted for 41 other illnesses, not a trial that assigned vaccines by chance. [24]

  11. 12

    Fewer deaths in the weeks after a COVID jab in the Netherlands

    Dutch researchers looked at 75,421 people who received COVID vaccines and died between January and November 2021. [25] Their average age was 79.8. [25] Deaths were 44% less frequent in the three weeks after a dose than in later periods. [25] Deaths were 16 times more frequent after a registered positive COVID test. [25]

    Why it matters — Each person who died is compared with themselves at other times, which cancels out lasting differences such as frailty and other illnesses. [25] In late 2021 Dutch deaths ran above what COVID deaths alone explained, which raised the question of other causes. [25]

  12. 13

    Stopping statins at 75 did not raise deaths in France

    A French trial randomly split 1,160 healthy people, average age 80, who took statins to prevent heart disease. [26] One group stopped their statins and the other kept taking them, for three years. [26] In the group that stopped, bad cholesterol rose 50% within three months. [26] After three years 7.2% of the stoppers had died, against 7.9% of those who continued, and heart attacks and strokes did not differ. [26]

    Why it matters — Earlier studies in Denmark and Italy found about 30% more heart trouble after stopping, but they did not record why people stopped. [26] A US cardiologist said the result will not change care for most people over 75. [26]

  13. 14

    German psilocybin trial missed its main target

    Psilocybin is the drug in magic mushrooms. The EPISODE trial at two German centres enrolled 144 people whose depression had resisted other treatment. [27] With therapy sessions, they got 25 mg of psilocybin, 5 mg, or nicotinamide, a vitamin used as the comparison. [27] After six weeks, 17.0% responded on 25 mg, 12.5% on 5 mg and 10.6% on the vitamin. [27] The difference was not statistically significant. [27] Thoughts of suicide on dosing days were reported by 4% on 25 mg, against 1% to 2% otherwise. [27]

    Why it matters — Because its main comparison failed, no further formal tests were run. [27] Two serious reactions followed the 25 mg dose, including one case of lasting visual disturbance. [27]

  14. 15

    In Sweden, one psilocybin dose faded within a year

    A Stockholm trial gave 35 people with recurring depression one 25 mg dose of psilocybin or niacin, a vitamin used as the comparison, plus five support sessions. [28] Depression scores were better on psilocybin at day 8, day 15 and day 42. [28] By day 365 the difference was no longer significant. [28] Two people on psilocybin had severe, lasting anxiety that needed medical care. [28]

    Why it matters — Psilocybin has been put forward as fast-acting with lasting effects, and here people's own ratings were better from day 2. [28] Those self-ratings stayed better until about day 102. [28]

  15. 16

    England's public health service ran its own psilocybin trial

    A trial at one NHS site in England gave 60 people with hard-to-treat depression 25 mg of psilocybin or a dummy, with preparation and support. [29] It was designed to test whether such a trial can be run, and 59 of 60 completed every follow-up. [29] At week 3 depression scores were 10.41 points better on psilocybin, and the gap held at week 6. [29] Non-serious side effects numbered 164 on psilocybin and 123 on the dummy. [29]

    Why it matters — It tested whether psilocybin therapy can run inside a public health service. [29] The authors say the results support a larger confirming trial. [29]

  16. 17

    Compass says its psilocybin drug passed two big trials

    In February, Compass Pathways released results from two late-stage trials of its psilocybin drug, COMP360, for severe depression. [30] Patients on the drug improved more on a depression scale than the comparison group. [30] It could become the first psilocybin medicine on the market, and the second psychedelic after Spravato, a ketamine-based spray. [30] A US psychiatrist not involved said the data probably meet the bar for approval, without being miraculous. [30]

    Why it matters — The company released the headline in a press statement, and fuller data are needed to judge how much patients gain. [30] Psilocybin could be approved in the US as early as next year. [31]

  17. 18

    Oregon's legal mushroom centres, studied

    Oregon lets most adults over 21 take psilocybin at licensed centres with a supervisor and no prescription. [31] A study published on 19 August followed almost 350 of the more than 20,000 people who have gone through the programme. [31] More than half called it one of the most meaningful experiences of their lives, and four had serious reactions. [31] Three reported new thoughts of dying or suicide a week later, and that number doubled by three months. [31]

    Why it matters — It is the most rigorous look yet at psilocybin outside a medical trial. [31] About a third of participants had household incomes above 200,000 dollars, and the researchers say the low number of bad reactions may partly reflect who chose to join. [31]

  18. 19

    Repeated psilocybin doses for OCD

    Obsessive-compulsive disorder, OCD, involves intrusive, unwanted thoughts and compulsive behaviour. [33] A small trial gave 15 people with OCD weekly psilocybin sessions, and some got a sedative as a comparison. [32] After eight weeks and at least four high doses, 73.3% had responded and 40% were in remission. [32] The effect shrank but stayed substantial at six months. [32] A review found 40% to 60% of OCD patients get partial or no relief from existing treatment. [33]

    Why it matters — The same review found stronger signs of benefit for psilocybin than for cannabis, though it had to include unpublished results. [33] The trial's main aim was safety, and it had only 15 people. [32]

  19. 20

    OCD takes about 13 years to be diagnosed

    The American Psychological Association reports that people with OCD have symptoms for nearly 13 years, on average, before a correct diagnosis. [34] OCD affects nearly 10 million people in the US, and more than 80% of cases are estimated to be undiagnosed. [34] As few as 2% of those diagnosed may be getting the recommended treatment. [34] That treatment, exposure and response prevention, teaches people to live with the thoughts without acting on them. [34]

    Why it matters — People with OCD face a suicide risk five times that of the general population. [34] Frightening intrusive thoughts are sometimes mistaken for a sign of danger to self or others, leading to hospital stays. [34]

  20. 21

    A serotonin-blocking drug added to OCD treatment

    Ondansetron is a drug that blocks one type of receptor for serotonin, a chemical messenger. [35] A review pooled five trials with 289 adults whose OCD persisted despite standard treatment. [35] Adding ondansetron improved symptom scores more than a dummy pill at week 4, week 8 and week 12. [35] At week 8 the gain was 5.53 points on the standard OCD scale. [35] The trials were small, and results varied between them. [35]

    Why it matters — A large share of adults with OCD keep their symptoms despite the best first-line treatment with therapy or antidepressants. [35]

  21. 22

    OCD therapy by video worked about as well

    Cognitive behavioural therapy teaches people to change how they respond to thoughts and fears. A review of 61 trials with 3,710 people with OCD compared ways of delivering it. [36] Face-to-face, remote, guided self-help, intensive and family-involved therapy all worked about equally well. [36] Group therapy did less than individual therapy, and self-help done alone did less than most formats. [36] More people dropped out of self-help done alone. [36]

    Why it matters — How therapy was delivered mattered less than whether anyone guided it: nearly every format beat self-help done alone. [36]

  22. 23

    Acceptance therapy tested for OCD across cultures

    Acceptance and commitment therapy teaches people to make room for difficult thoughts rather than fight them. A review pooled nine trials of it for OCD, from the US, Denmark, Iran and South Korea. [37] It worked moderately better than no treatment or drug-only comparisons. [37] It did no better than other talking therapies. [37] Once the comparisons were matched, it worked about equally in Eastern and Western studies. [37]

    Why it matters — Five of the nine trials came from Iran, so the evidence leans heavily on one country. [37]

  23. 24

    For children with OCD, exposure therapy comes first

    An umbrella review brought together 28 earlier reviews covering 24,762 young people under 18 with OCD. [38] Cognitive behavioural therapy, especially exposure and response prevention, had the largest and longest-lasting effects. [38] Antidepressants of the SSRI type worked moderately, and combining them with therapy may help in severe cases. [38] Therapy delivered over the internet was also reviewed. [38]

    Why it matters — The authors say treatment needs to become easier to reach and better suited to children's ages. [38]

  24. 25

    Doubts over plastic found in human organs

    Studies reported micro- and nanoplastics in brains, testes, placentas and arteries. [39] In January the Guardian identified seven such studies challenged by other researchers in the same journals. [39] One analysis listed 18 studies that did not account for human tissue giving signals that look like common plastics. [39] A researcher at a German environmental research centre said fat gives false readings for polyethylene, and the brain is about 60% fat. [39]

    Why it matters — The brain study's senior author said the criticism was mostly not based on data. [39] The BMJ, a medical journal, reported in March that new research suggests plastic levels may have been overestimated. [40]

  25. 26

    Two reviews disagree on how much plastic is inside us

    A review of 26 studies with 564 human samples found counts from under one to several thousand particles per gram of tissue. [41] It says cleaner, plastic-free lab methods are lowering the overestimates. [41] A second review of 190 measurements found the opposite for solid organs. [42] It says automated machines found nearly 70 times more particles in tissues like placenta and lung than older hand methods. [42]

    Why it matters — Both reviews blame the measuring methods, and they point in opposite directions. [41][42] The first review calls for standard lab methods, because studies done in different ways cannot be compared. [41]

  26. 27

    Plastic particles and cancers of the bladder and prostate

    A review in the journal Communications Medicine looked at micro- and nanoplastics and cancers of the prostate, bladder and kidney. [43] Some studies have measured particles inside prostate and bladder tumours, with higher amounts linked to eating take-out food often. [43] Suggested ways they could cause harm include inflammation and chemicals added to plastics. [43] The review says the evidence is not yet enough to link them directly to these cancers. [43]

    Why it matters — The same particles are being tested as carriers for cancer drugs, so the review covers both a possible harm and a possible use. [43]

  27. 28

    Vaping plus smoking and lung cancer under 50

    Researchers at Ohio State University compared 256 adults under 50 with lung cancer against 2,921 people without cancer. [44] Those who only smoked had about five times the odds of lung cancer. [44] Those who both smoked and vaped had about 13.8 times the odds. [44] Most of the young people's tumours, 72%, were adenocarcinomas, a type that starts in the lung's gland cells. [44]

    Why it matters — It is a case-control study, which compares the past habits of people with and without the disease, so it shows a link rather than proof. [44] Lung cancer is the leading cause of cancer death worldwide, including in young adults. [44]

  28. 29

    Smoking and vaping rising again among British youth

    A January analysis in the BMJ says current smoking among 11 to 17 year olds in Great Britain rose from 3% in 2021 to 5.4% in 2025. [45] Current vaping in that age group more than doubled, from 3.2% to 7.2%. [45] Among 18 to 24 year olds in England, current vaping rose from 5.6% in 2019 to 24.2% in 2023. [45] Globally, children aged 13 to 15 are about nine times as likely to vape as adults. [45]

    Why it matters — The authors say the rises in smoking may be partly linked to vaping, and that new UK laws will need follow-up. [45] Nicotine addiction can set in fast in young people. [45]

  29. 30

    A 15-year-old with air leaking inside the chest

    Doctors in Hull, England, reported a 15-year-old who arrived at the emergency department with chest pain and trouble breathing. [46] The teenager vaped about 500 puffs a day and also used cannabis. [46] A scan showed pockets of air around the spinal canal, between the lungs and under the skin, called air leak syndrome. [46] The doctors believe the cannabis and vaping likely damaged the teenager's food pipe or windpipe. [46]

    Why it matters — The team says one patient cannot prove a link, and only a few similar cases exist. [46] About one in five UK children aged 11 to 17 has tried vaping. [46]

  30. 31

    Smoking and vaping together hurt lungs most

    A study of 222 young adults, median age 26, tested their breathing with a spirometer, which measures how much air the lungs push out. [47] Smokers, vapers and people who did both all breathed out less in the first second than people who used neither. [47] People who did both did worst, and people who only vaped did least badly. [47] A separate review found non-smokers who vape had 1.90 times the risk of breathing symptoms of people who never vaped. [48]

    Why it matters — Vaping alone did less harm than smoking in both studies, and still more than using neither. [47][48]

  31. 32

    Metals from vape coils found in breath

    Researchers followed college students for three months, testing their vapes and their breath. [49] Ceramic and mesh heating coils released different metals, including lead and cadmium from mesh coils. [49] Matching metals appeared in the vapers' exhaled breath. [49] A breath marker of airway inflammation rose the longer people had vaped. [49]

    Why it matters — It shows the heating coil, not just the liquid, is a source of what reaches the lungs. [49] It lasted three months, and the authors call for more research. [49]

  32. 33

    Warnings about addiction are the weakest anti-vaping message

    A review looked at 16 studies of how 21,427 young people responded to anti-vaping messages. [50] Messages naming specific health harms and the chemicals in vapour worked best at lowering the wish to vape. [50] Messages warning that nicotine is addictive were judged the least effective. [50] The authors recommend a new US warning label listing specific health effects. [50]

    Why it matters — Messages that raised how risky vaping feels were the ones most likely to reduce it. [50]

  33. 34

    US teens: vaping falling, anxiety a top reason

    A study of the US National Youth Tobacco Survey, from 2018 to 2023, found e-cigarette use among middle and high school students trending down. [51] Students who only vaped outnumbered those who only smoked by about five to one. [51] Anxiety was consistently one of the top three reasons current users gave for vaping. [51]

    Why it matters — The authors say the five-to-one gap contradicts claims that vapes mainly help people quit smoking. [51]

  34. 35

    Most facial weakness after stroke recovers within days

    Researchers in Bergen, Norway, studied 5,987 stroke patients in their first week in hospital. [52] Weakness in the face was seen in 43%, and 3% had complete paralysis of one side. [52] By day 2, 25% had fully recovered, while 63% still had symptoms at day 7. [52] Patients given a clot-dissolving drug through a vein recovered better. [52]

    Why it matters — Slower recovery went with more severe loss of movement and feeling elsewhere in the body. [52] The authors say it shows the need for ongoing checks and rehabilitation. [52]

02 Lesson why it matters

A treatment only works on the nights it is actually used

A mask that holds the airway open does nothing while it sits beside the bed, so what a person gets is how well it works times how long it is worn.

The twist

A CPAP mask stops almost every blocked breath while it is on. People wear it about half the night, so a mouth guard that stops fewer blocked breaths can do about as much for blood pressure.

How it works

  1. A trial measures what a treatment does while it is being used
  2. At home people use it for part of the night, or for a few months, and then stop
  3. What a person actually gets is the effect multiplied by the time it is used
  4. So a weaker treatment people keep using can match a stronger one they take off
  5. And a trial whose patients barely used a treatment can make a good one look useless

The same force, elsewhere today

Where this chain is also running, in today's other stories.

  • OCD therapy by video

    Self-help done alone lost more people along the way than guided formats, and it helped less.

  • OCD takes about 13 years to be diagnosed

    Exposure therapy works, but as few as 2% of people diagnosed in the US receive it, so its effect reaches almost nobody.

  • Plans against resistance took five years to show

    Countries wrote plans faster than they put them into practice, and resistance changed only about five years after a plan was adopted.

Where you've seen this

Seat belts

a belt protects only on the trips it is buckled

Software updates

a security fix installed on half the computers protects half of them

Glasses

the right prescription does nothing while the glasses sit in a drawer

The catch

Use does not explain every failure. Some treatments do little even when taken exactly as intended, and a trial can also mix people a treatment helps with people it harms.

And the whole of it

A doctor sees a prescription written, a trial sees an average, and a person in bed sees a hot mask at 3 a.m. Anyone who has stopped a course of tablets early has been one of the people inside that average.

03 Truth what's really going on

What is really going on

The CPAP mask stops almost every blocked breath, but people in trials wore it for about 4.5 hours a night, and up to half give it up within a year. [9][4][3] Drug companies are now testing pills and a weekly injection as other ways to treat it. [5][7] The leading pill, Apnimed's AD109, cut blocked breaths in people who could not or would not use CPAP, without making them less tired. [5]

Why it works on us — Blocked breaths per hour is a number that falls neatly on a chart. In the AD109 trial that number fell while people felt no less tired than on a dummy pill. [5]

Who gains

  • Apnimed — Its AD109 pill is aimed at the people who cannot or will not use CPAP, the exact group its 646-person trial enrolled. [5]
  • The maker of tirzepatide — The weekly injection is the only US drug approved to treat the blocked airway itself, in adults with obesity, a group of about 10% of US adults. [3][7]
  • Revolution Medicines — Its pancreatic cancer pill Rasonque was approved six months ahead of the regulator's deadline, for a cancer with few other options. [13][12]
  • Scholar Rock — Isembyld is approved only for patients already on an SMN2-targeting drug, so it is sold as an addition to existing treatment rather than a replacement. [14]
  • Plastics industry lobbyists — Researchers told the Guardian that faulty studies of plastic in the body could help lobbyists dismiss real concerns about plastic pollution. [39]

Who pays

  • People with sleep apnoea who stop treatment — In 538 people who declined treatment, apnoea usually worsened over about four years. [10]
  • People who take AD109 — Dry mouth, nausea, insomnia and trouble passing urine were the commonest side effects, and one in five stopped the pill. [5]
  • Children in intensive care and in poorer countries — They are the most affected by antibiotic-resistant infections, and few antibiotics are made in child-friendly forms. [18]
  • People with OCD — They wait nearly 13 years on average for a correct diagnosis, and as few as 2% of those diagnosed in the US get the recommended therapy. [34]
  • Young people in Great Britain — Current vaping among 11 to 17 year olds more than doubled between 2021 and 2025, and nicotine addiction can set in fast at that age. [45]

What nobody knows yet

Open questions from across today’s stories — ours included.

  • 01

    Whether CPAP prevents heart attacks and strokes.

    Trials have not shown a heart benefit on average, and patients in CPAP trials used the mask for 4.5 hours a night on average, and short use may hide part of the mask's effect in those trials. [9][4]

  • 02

    Whether AD109 will be approved, and whether people will keep taking it.

    It is still experimental, and 21.2% of people on it stopped within six months because of side effects. [3][5]

  • 03

    Whether the mask helps some people's hearts and harms others'.

    A computer model of the SAVE trial suggests it, but the authors say it has not been checked on a separate group of patients. [9]

  • 04

    How much plastic is really inside human tissue.

    One review says cleaner lab methods lower the counts, while another says automated machines find nearly 70 times more in solid organs than older methods. [41][42]

  • 05

    Whether psilocybin helps depression beyond the first weeks.

    The Stockholm trial's difference was gone by one year, the German EPISODE trial missed its six-week target, and Compass has released only headline results. [28][27][30]

  • 06

    Why vaccinated veterans had fewer heart events of every kind, not only those tied to COVID.

    The lead researcher thinks untested COVID infections explain it, but the study used health records rather than assigning vaccines by chance. [22][23]

  • 07

    Whether stopping statins after 75 is safe outside France.

    The trial had 1,160 people in a country with low heart death rates, and its co-author says the result must be confirmed in other populations. [26]

  • 08

    How long lab-grown islet cells keep making insulin.

    Donor islets put 76% of recipients in one study back on insulin within two years, and the stem-cell cells still need immune-suppressing drugs. [17][16]

  • 09

    Whether vaping itself raised the lung cancer odds in young adults who also smoked.

    The Ohio study compared past habits after diagnosis, which shows a link and cannot show the cause. [44]

04 Hope carry this

A daily pill for advanced pancreatic cancer was approved in the US on 26 August. In its trial, people taking it lived a median 13.2 months, against 6.7 months on chemotherapy.

Also true today

  • In an early trial of insulin-making cells grown from stem cells, 10 of 12 people with type 1 diabetes stopped needing insulin injections.
  • People with spinal muscular atrophy, a rare disease of the nerves that control movement, now have an approved drug aimed at their muscle loss. In its trial, young patients' movement skills improved over a year, while those on a dummy drug declined.
  • A review of six trials with 800,000 men found PSA blood tests likely prevent about two prostate cancer deaths for every 1,000 men screened.

Across the beats