Trazodone increases arousal threshold in obstructive sleep apnoea.

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Serval ID
serval:BIB_4B2B41993F3E
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Trazodone increases arousal threshold in obstructive sleep apnoea.
Journal
European Respiratory Journal
Author(s)
Heinzer R.C., White D.P., Jordan A.S., Lo Y.L., Dover L., Stevenson K., Malhotra A.
ISSN
0903-1936
Publication state
Published
Issued date
2008
Peer-reviewed
Oui
Volume
31
Number
6
Pages
1308-1312
Language
english
Abstract
A low arousal threshold is believed to predispose to breathing instability during sleep. The present authors hypothesised that trazodone, a nonmyorelaxant sleep-promoting agent, would increase the effort-related arousal threshold in obstructive sleep apnoea (OSA) patients. In total, nine OSA patients, mean+/-sd age 49+/-9 yrs, apnoea/hypopnoea index 52+/-32 events.h(-1), were studied on 2 nights, one with trazodone at 100 mg and one with a placebo, in a double blind randomised fashion. While receiving continuous positive airway pressure (CPAP), repeated arousals were induced: 1) by increasing inspired CO(2) and 2) by stepwise decreases in CPAP level. Respiratory effort was measured with an oesophageal balloon. End-tidal CO(2 )tension (P(ET,CO(2))) was monitored with a nasal catheter. During trazodone nights, compared with placebo nights, the arousals occurred at a higher P(ET,CO(2)) level (mean+/-sd 7.30+/-0.57 versus 6.62+/-0.64 kPa (54.9+/-4.3 versus 49.8+/-4.8 mmHg), respectively). When arousals were triggered by increasing inspired CO(2) level, the maximal oesophageal pressure swing was greater (19.4+/-4.0 versus 13.1+/-4.9 cm H(2)O) and the oesophageal pressure nadir before the arousals was lower (-5.1+/-4.7 versus -0.38+/-4.2 cm H(2)O) with trazodone. When arousals were induced by stepwise CPAP drops, the maximal oesophageal pressure swings before the arousals did not differ. Trazodone at 100 mg increased the effort-related arousal threshold in response to hypercapnia in obstructive sleep apnoea patients and allowed them to tolerate higher CO(2) levels.
Keywords
Adult, Arousal/drug effects, Female, Humans, Male, Middle Aged, Polysomnography, Sleep Apnea, Obstructive/physiopathology, Sleep Initiation and Maintenance Disorders/drug therapy, Trazodone/therapeutic use
Pubmed
Web of science
Open Access
Yes
Create date
14/10/2009 10:44
Last modification date
20/08/2019 13:59
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