Authors: Nils Henrik Holmedahl Britt Øverland Ove Fondenes Ivar Ellingsen Jon Andrew Hardie
Publish Date: 2014/12/13
Volume: 19, Issue: 3, Pages: 921-930
Abstract
More than half of patients with chronic obstructive pulmonary disease COPD experiences sleeprelated problems and about one fourth uses hypnotics regularly We explored what the effect zopiclone a commonly used hypnotic had on nocturnal gas exchange and the apnea/hypopnea frequency in stable COPDRandomized crossover study of 31 ten males inpatients at a pulmonary rehabilitation hospital median age 64 years of which 20 had a forced expiratory volume first second 50 of predicted Subjects investigated in randomized order of either baseline sleep or intervention with 5 mg zopiclone by polysomnography including transcutaneous measurement of carbon dioxide pressure increased ΔPtcCO2Zopiclone increased the mean ΔPtcCO2 from baseline both in rapid eye movement REM sleep nonREM sleep and even in stage N0 awake after sleep onset with a mean SD of 025 040 kPa 022 032 kPa and 014 027 kPa respectively Subjects with sleep hypoventilation as defined by the American Academy of Sleep Medicine increased from 6 subjects 19 to 13 subjects 42 P = 0020 REM sleep minimum oxygen saturation minSpO2 did not change significantly from baseline median interquartile range IQR minSpO2 818 121 to zopiclone sleep median IQR minSpO2 800 120 P = 0766 Interestingly zopiclone reduced the number of apneas/hypopneas per hour AHI in subjects with overlap AHI ≥ 15 with a median difference IQR of −85 78 N = 11 P = 0016PSG hardware and software were provided by ResMed Norway The authors wish to thank the staff at Glittreklinikken for the enthusiastic support and participation in the data collection Financial support was received from the Norwegian ExtraFoundation for Health and Rehabilitation LHL’s Research fund Glittreklinikken and the Norwegian National Centre of Excellence in Home Mechanical Ventilation Minor grants were received from the Norwegian Lung Medicine Society/Takeda Nycomed Major Eckbo’s endowments and the University of Bergen
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