The effect of temazepam on respiration in elderly insomniacs with mild sleep apnea.
ABSTRACT This study evaluated the respiratory effect of temazepam in elderly subjects (mean age 65 +/- 3.8 years), with mild sleep apnea. The 15 subjects of this report were enrolled in a larger randomized trial comparing pharmacological and behavioral treatments for insomnia. Seven subjects received temazepam 15-30 mg/day either alone or in combination with behavior therapy, and eight subjects received placebo or behavior therapy. The mean baseline respiratory disturbance index (RDI) was 9.2 +/- 2.8 for the nondrug and 8.8 +/- 5.3 for the temazepam group. There were no significant time, group or interaction effects. There was no increase in the RDI in elderly subjects with mild respiratory apnea receiving 15-30 mg of temazepam.
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ABSTRACT: INTRODUCTION: Obstructive sleep apnea syndrome is a common public health problem in the general population. The important health-related consequences of obstructive sleep apnea include cardiovascular disorders, such as myocardial infarction and hypertension, stroke, sudden death and difficult blood sugar control related to diabetes mellitus. The current main treatment options include body weight loss, continuous positive airway pressure, oral appliances and surgical treatment. The effects of pharmacotherapy on sleep apnea continue to be controversial and supplemental only. Current medications for sleep apnea mainly act through reducing risk factors, treating predisposing endocrine disorders, improving residual sleepiness post management and controlling associated hypertension and metabolic disorders. AREAS COVERED: This article discusses the pharmacotherapy of sleep apnea, including ventilatory stimulants, serotoninergic and REM sleep suppressant agents, acetylcholinesterase inhibitors, medications for predisposing endocrine disorders, stimulants, associated sleep apnea health problems and sleep apnea patient anesthetic precaution. Weight loss is not a direct pharmacological approach and is only briefly mentioned. EXPERT OPINION: At present, there is no appropriate pharmacological treatment for obstructive sleep apnea. There are adjunct treatments such as anti-allergy treatment, and, if residual sleepiness is present, nonamphetaminic stimulants can help. Usage of these stimulants will, however, produce negative effects in an anticipated rate of about 10% of subjects taking these medications.Expert Opinion on Pharmacotherapy 03/2012; 13(6):841-57. DOI:10.1517/14656566.2012.666525 · 3.09 Impact Factor
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ABSTRACT: Die Arbeit fa\t beschriebene Änderungen des Schlafes und der nächtlicher Atmung für 43 Medikamente zusammen, die bei Patienten mit schlafbezogenen Atmungsstörungen (SBAS) geprüft wurden. Zum Teil wurde eine Besserung der SBAS gesehen, diese war aber in der Regel klinisch unbedeutend oder konnte in anderen Studien nicht nachvollzogen werden. Die Ursache hierfür ist wahrscheinlich eine erhebliche Nacht-zu-Nacht-Variabilität der Zahl nächtlicher Atempausen. Lediglich für Patienten mit der Kombination Herzinsuffizienz/schlafbezogene Atmungsstörung scheint eine medikamentöse Therapie mit Theophyllin oder nächtlicher Gabe von Sauerstoff sinnvoll. Zukünftige Untersuchungen und Bewertungen von Medikamenten sollten die Nacht-zu-Nacht-Variabilität unbedingt mit einbeziehen. 43 different drugs have been found in studies on medical treatment of sleep apnea syndromes. The results are inconsistent, sometimes a decrease of the severity of sleep disordered breathing could be reported. We assume that the high night-to-night variability of sleep disordered breathing which was not considered in the various studies is responsible for the outcome. However oxygen or theophylline could be proven as effective in cases of congestive heart failure and central sleep apnea. Further studies on pharmacologic therapy have to include data about the night-to-night variability.Somnologie - Schlafforschung und Schlafmedizin 05/1998; 2(2):77-88. DOI:10.1007/s11818-998-0012-1
Article: [Insomnia and sleep apnea.][Show abstract] [Hide abstract]
ABSTRACT: The presence of insomnia in patients with sleep apnea seems paradoxical as excessive sleepiness is one of the major symptoms of sleep apnea. However, recent research has shown that about half of patients with sleep disorder breathing experience insomnia. Moreover, patients complaining of insomnia or non-restorative sleep may also present with moderate to severe sleep apnea syndromes. Thus, in recent years, clinicians have become more aware of the possible association between insomnia and sleep apnea. This article reviews data published on different aspects of this co-occurrence.Revue des Maladies Respiratoires 02/2014; 31(2):181-188. · 0.49 Impact Factor