Role of protriptyline and acetazolamide in the sleep apnea/hypopnea syndrome.
The role of drug therapy in the treatment of the sleep apnea/hypopnea syndrome is unclear. In a randomised, double-blind, placebo-controlled study, we investigated the value of 14-day therapy with protriptyline (20 mg daily) or acetazolamide (250 mg 4 times per day) on symptoms and on the frequency of apneas, hypopneas, arousals, and 4% desaturations in 10 patients with obstructive sleep apnea/hypopnea syndrome. Overall, protriptyline did not have a significant effect either on symptoms or on any of the above polysomnographic criteria. Acetazolamide reduced the apnea/hypopnea frequency [placebo 50 +/- 26 (SD); acetazolamide 26 +/- 20/h of sleep, p less than 0.03] and tended to decrease the frequency of 4% desaturations (placebo 29 +/- 20; acetazolamide 19 +/- 16/h of sleep, p = 0.06). Despite these physiological improvements, acetazolamide did not significantly improve symptoms and paraesthesiae were common. Contrary to earlier studies, we conclude that protriptyline may have a limited role in the treatment of the sleep apnea syndrome. The reason why acetazolamide produced a physiological, but not a symptomatic, response requires further investigation.
Whyte
K F
KF
Rayne Laboratory, Department of Respiratory Medicine, University of Edinburgh, Scotland.
Gould
G A
GA
Airlie
M A
MA
Shapiro
C M
CM
Douglas
N J
NJ
D000086:Acetazolamide / Q000009:adverse effects / Q000627:therapeutic use*; D000328:Adult; D000368:Aged; D002986:Clinical Trials as Topic; D003986:Dibenzocycloheptenes / Q000627:therapeutic use*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic; D011530:Protriptyline / Q000009:adverse effects / Q000627:therapeutic use*; D012891:Sleep Apnea Syndromes / Q000188:drug therapy*
D003986:Dibenzocycloheptenes; D011530:Protriptyline; D000086:Acetazolamide