1
|
Berger M, Solelhac G, Marchi NA, Dussez R, Bradley B, Lecciso G, Heiniger G, Bayon V, Van Den Broecke S, Haba-Rubio J, Siclari F, Heinzer R. Effect of oxybutynin and reboxetine on obstructive sleep apnea: a randomized, placebo-controlled, double blind, crossover trial. Sleep 2023:7067307. [PMID: 36861433 DOI: 10.1093/sleep/zsad051] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Indexed: 03/03/2023] Open
Abstract
STUDY OBJECTIVES Although recent investigations combining noradrenergic and antimuscarinic drugs have shown promising short-term results to treat obstructive sleep apnea (OSA), the mid-term effect and optimal dosage remain uncertain. The present study aimed to evaluate the effect of one week of 5 mg oxybutynin and 6 mg reboxetine (oxy-reb) on OSA versus placebo. METHODS We performed a randomized, placebo-controlled, double-blind, crossover trial comparing the effect of one week of oxy-reb versus one week of placebo on OSA severity. At-home polysomnography was performed at baseline and after each week of intervention. RESULTS Fifteen participants (male 66.7%) aged 59 [44-62] years (median [interquartile range]) with a mean body mass index of 33.1 ± 6.6 kg.m -2 were included. No significant difference in apnea-hypopnea index (AHI) was observed between conditions (estimated marginal means (95% confidence interval) at baseline: 39.7 (28.5-55.3); oxy-reb: 34.5 (22.7-52.3); placebo: 37.9 (27.1-52.9); p=0.652), but oxy-reb improved average oxygen desaturation (p=0.016) and hypoxic burden (p=0.011) and lowered sleep efficiency (p=0.019) and rapid eye movement (REM) sleep (p=0.002). Moreover, participants reported reduced sleep quality during the week of oxy-reb compared to the week of placebo (4.7 (3.5; 5.9) vs. 6.5 (5.5; 7.5) on a 0-10 visual analogic scale, respectively; p=0.001). No significant differences in sleepiness, vigilance and fatigue were observed. No serious adverse events occurred. CONCLUSION Administration of oxybutynin 5 mg and reboxetine 6 mg did not improve OSA severity assessed by AHI, but did alter sleep architecture and sleep quality. Reduced average oxygen desaturation and hypoxic burden were also observed.
Collapse
Affiliation(s)
- M Berger
- Center for Investigation and Research in Sleep, Department of Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.,Sainbiose, DVH, Inserm U1059, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - G Solelhac
- Center for Investigation and Research in Sleep, Department of Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - N A Marchi
- Center for Investigation and Research in Sleep, Department of Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - R Dussez
- Center for Investigation and Research in Sleep, Department of Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - B Bradley
- Center for Investigation and Research in Sleep, Department of Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - G Lecciso
- Center for Investigation and Research in Sleep, Department of Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - G Heiniger
- Center for Investigation and Research in Sleep, Department of Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - V Bayon
- Center for Investigation and Research in Sleep, Department of Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - S Van Den Broecke
- Center for Investigation and Research in Sleep, Department of Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - J Haba-Rubio
- Center for Investigation and Research in Sleep, Department of Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - F Siclari
- Center for Investigation and Research in Sleep, Department of Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - R Heinzer
- Center for Investigation and Research in Sleep, Department of Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| |
Collapse
|
2
|
Van Den Broecke S, Jobard O, Montalescot G, Bruyneel M, Ninane V, Arnulf I, Similowski T, Attali V. La polysomnographie très précoce dans les syndromes coronariens aigus est faisable : résultats d’étude pilote. Rev Mal Respir 2014. [DOI: 10.1016/j.rmr.2013.10.086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|