L-tryptophan in the treatment of impaired respiration in sleep.
15 subjects (mean age: 48.2 yr; 13 males, 2 females) with sleep apnea (12 obstructive, 3 central) were treated with an average dose of 2500 mg L-tryptophan (L-T) at bedtime. Comparison of pre- and post-drug polysomnograms showed significant improvement in obstructive sleep apnea but not with central sleep apnea. Most dramatic improvement is seen in subjects with obstructive sleep apnea in non-REM sleep only, but severity of apnea appears to be the most important factor determining improvement. L-T increased REM time and shortened REM latency but had no other significant effects on sleep architecture. Serotoninergic activity with a defect in feedback control of tryptophan-serotonin metabolism is postulated as a potential mechanism in the pathophysiology of obstructive sleep apnea. The enhanced usefulness of L-T in combination with protriptyline is predicted based on early preliminary work at the OSU Sleep Center. The Potential influence of dietary intake on respiratory automaticity is reviewed.
D002986:Clinical Trials as Topic; D004032:Diet; D004359:Drug Therapy, Combination; D005246:Feedback; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic; D009765:Obesity / Q000150:complications; D011530:Protriptyline / Q000008:administration & dosage; D012701:Serotonin / Q000378:metabolism; D012891:Sleep Apnea Syndromes / Q000188:drug therapy* / Q000503:physiopathology; D012895:Sleep, REM; D014364:Tryptophan / Q000008:administration & dosage / Q000378:metabolism / Q000627:therapeutic use*
D012701:Serotonin; D011530:Protriptyline; D014364:Tryptophan