The effect of sildenafil on sleep respiratory parameters and heart rate variability in obstructive sleep apnea

The effect of sildenafil on sleep respiratory parameters and heart rate variability in obstructive sleep apnea

Author Neves, Christiane Autor UNIFESP Google Scholar
Tufik, Sergio Autor UNIFESP Google Scholar
Monteiro, Marina Ariza Autor UNIFESP Google Scholar
Chediek, Felipe Autor UNIFESP Google Scholar
Jose, Fabio Freire Autor UNIFESP Google Scholar
Roizenblatt, Suely Autor UNIFESP Google Scholar
Institution Universidade Federal de São Paulo (UNIFESP)
Abstract Objective: To evaluate the magnitude of effects of sildenafil on respiratory parameters and heart rate variability (HRV) in slow wave sleep (SWS) and REM sleep of patients with severe obstructive sleep apnea (OSA).Methods: Thirteen male patients with untreated severe OSA (aged 43 +/- 10 years, body mass index of 26.7 +/- 1.9 kg/m(2)) were studied on two nights, one with sildenafil 50 mg and one with a placebo, in a double-blind, randomized fashion. All-night polysomnography and HRV were simultaneously recorded. Short-term HRV measures were performed in apnea-free intervals. Respiratory parameters were separately assessed in non-REM and REM sleep and compared to total sleep time (TST). Short-term HRV analysis was conducted in samples with regular respiration obtained in SWS and REM sleep.Results: Comparing to placebo, during sildenafil night there was an increase in apnea-hypopnea index (AHI) in TST and also in non-REM and REM sleep. Increase in central AHI occurred in non-REM sleep; increase in obstructive AHI and decrease in oxyhemoglobin saturation occurred in both non-REM and REM sleep. Additionally, an increase in arousal index and in low/high frequency component of HRV ratio (LF/HF) was significant only in REM sleep. Correlation between sleep architecture and respiratory parameters were more frequent in non-REM sleep for placebo and in REM sleep for sildenafil.Conclusion: in severe OSA, the use of sildenafil 50 mg at bedtime plays a detrimental role on respiratory parameters in both non-REM and REM sleep, fragmentation in REM sleep, and a prolonged increase in LH/HF component of HRV after resumption of ventilation. (C) 2010 Elsevier B.V. All rights reserved.
Keywords Apnea
Sleep
Sildenafil
Heart rate variability
Hypoxemia
Nitric oxide
Language English
Sponsor Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
Associacao Fundo Incentivo a Psicofarmacologia
Date 2010-06-01
Published in Sleep Medicine. Amsterdam: Elsevier B.V., v. 11, n. 6, p. 545-551, 2010.
ISSN 1389-9457 (Sherpa/Romeo, impact factor)
Publisher Elsevier B.V.
Extent 545-551
Origin http://dx.doi.org/10.1016/j.sleep.2010.02.010
Access rights Closed access
Type Article
Web of Science ID WOS:000279424800008
URI http://repositorio.unifesp.br/handle/11600/32601

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