感冒和流感药物对阻塞性睡眠呼吸暂停及其潜在特征的影响：一项试点随机对照试验,Respirology

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感冒和流感药物对阻塞性睡眠呼吸暂停及其潜在特征的影响：一项试点随机对照试验
Respirology ( IF 6.9 ) Pub Date : 2021-01-24 , DOI: 10.1111/resp.14009
Luigi Taranto-Montemurro ₁ , Scott Sands ₁ , Ali Azarbarzin ₁ , Nicole Calianese ₁ , Daniel Vena ₁ , Lauren Hess ₁ , Sang-Wook Kim _{1,

2,

3} , David P White ₁ , Andrew Wellman ₁

Affiliation

背景和目的动物研究表明，α-1 肾上腺素能受体激动剂和抗毒蕈碱剂可改善睡眠期间颏舌肌的活动，并且可能是 OSA 药物治疗的候选药物。另一方面，如果在睡前服用，去甲肾上腺素能兴奋剂可能会促进觉醒或引起失眠症状，并且添加具有镇静作用的药物，如抗组胺药，可以减少这些副作用。在这项研究中，我们旨在确定 α-1 肾上腺素能激动剂（伪麻黄碱）和抗组胺药-抗毒蕈碱药（苯海拉明）的组合对 OSA 严重程度 (AHI)、颏舌肌反应性和其他内型特征（Vpassive、肌肉代偿、 LG 和唤醒阈值）。方法 10 名 OSA 患者进行了一项随机、安慰剂对照、双盲、交叉试验将一晚伪麻黄碱 120 毫克加苯海拉明 50 毫克 (DAW1033D) 与睡前服用安慰剂进行比较。通过 PSG 测量 AHI、颏舌肌对食管负压的反应性和内型特征。结果参与者的中位（四分位距）年龄为 50 (46-53) 岁，体重指数 (BMI) 为 34.3 (30.6-39.2) kg/m2。药物组合对 AHI（安慰剂组 21.6 (9.1-49.8) vs DAW1033D 37.9 (5.1-55.4) 个事件/小时，P > 0.5）或颏舌肌反应性（安慰剂组 6.0 (2.6-9.2) vs 4.0 (3.5)）没有影响-7.3) %/cm H2 O)。在表型性状中，只有 Vpassive 改善了 29 (3-55) % eupnoea，P = 0.03（平均 (95% CI)）。结论伪麻黄碱和苯海拉明的组合没有改善 OSA 的严重程度或颏舌肌反应性，但在上气道塌陷方面略有改善，这可能是由于药物的减充血作用。本研究的结果不支持使用这些药物治疗 OSA。

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Impact of cold and flu medication on obstructive sleep apnoea and its underlying traits: A pilot randomized controlled trial

BACKGROUND AND OBJECTIVE Animal studies indicate that alpha-1 adrenergic receptor agonists and antimuscarinic agents improve genioglossus muscle activity during sleep and may be candidates for the pharmacological treatment of OSA. On the other hand, noradrenergic stimulants may be wake-promoting or cause insomnia symptoms if taken before bedtime, and the addition of a medication with sedative properties, such as an antihistaminic, may reduce these side effects. In this study, we aimed to determine the effects of the combination of an alpha-1 adrenergic agonist (pseudoephedrine) and an antihistaminic-antimuscarinic (diphenhydramine) on OSA severity (AHI), genioglossus responsiveness and other endotypic traits (Vpassive , muscle compensation, LG and arousal threshold). METHODS Ten OSA patients performed a randomized, placebo-controlled, double-blind, crossover trial comparing one night of pseudoephedrine 120 mg plus diphenhydramine 50 mg (DAW1033D) to placebo administered prior to sleep. The AHI, genioglossus muscle responsiveness to negative oesophageal pressure and the endotypic traits were measured via PSG. RESULTS The participants' median (interquartile range) age was 50 (46-53) years and body mass index (BMI) was 34.3 (30.6-39.2) kg/m2 . The drug combination had no effect on AHI (21.6 (9.1-49.8) on placebo vs 37.9 (5.1-55.4) events/h on DAW1033D, P > 0.5) or genioglossus responsiveness (6.0 (2.6-9.2) on placebo vs 4.0 (3.5-7.3) %/cm H2 O). Amongst the phenotypic traits, only Vpassive was improved by 29 (3-55) % eupnoea, P = 0.03 (mean (95% CI)). CONCLUSION The combination of pseudoephedrine and diphenhydramine did not improve OSA severity or genioglossus responsiveness but induced a small improvement in upper airway collapsibility, possibly due to the decongestant effect of the medications. The results of this study do not support the use of these medications for OSA treatment.

更新日期：2021-01-24

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