Temazepam 10mg does not affect breathing and gas exchange in patients with severe normocapnic COPD.
BACKGROUND
Benzodiazepines can improve sleep quality, but are also thought to cause respiratory depression in patients with chronic obstructive pulmonary disease (COPD). The aims of this study were to assess the effects of temazepam on indices of circadian respiratory function, dyspnea, sleep quality, and sleepiness in patients with severe COPD and insomnia.


METHODS
In a double-blind, randomized, placebo-controlled, cross-over study in 14 stable patients with COPD (mean FEV(1) 0.99+/-0.3L) with insomnia, polysomnography with continuous transcutaneous capnography and oximetry, arterial gas sampling, hypercapnic ventilatory response, multiple sleep latency test, Epworth Sleepiness Scale, dyspnea and sleep visual analogue scales (VAS) were performed at baseline, after one week of temazepam 10mg at bedtime and after one week of placebo.


RESULTS
Temazepam did not cause statistically significant changes in mean transcutaneous carbon dioxide tension during sleep compared to placebo (5.9+/-1.0 kPa vs. 6.3+/-1.4 kPa, p-value 0.27), nor in mean oxygen saturation (92+/-3% vs. 92+/-2%, p-value 0.31), nor in any of the other investigated variables, except for the total sleep time and sleep latency VAS, which improved with temazepam.


CONCLUSIONS
One week usage of temazepam 10mg does not influence circadian respiratory function, dyspnea, and sleepiness in patients with stable, severe, normocapnic COPD and insomnia and it improves total sleep time and subjective sleep latency. However, this is a preliminary explorative study for assessing the feasibility to perform a larger study on this topic. The clinical implications of this study are very limited.
Stege
Gerben
G
Department of Pulmonology, Rijnstate Hospital, 6800 TA Arnhem, The Netherlands. gstege@alysis.nl
Heijdra
Yvonne F
YF
van den Elshout
Frank J J
FJ
van de Ven
Marjo J T
MJ
de Bruijn
Peter J
PJ
van Sorge
Adriaan A
AA
Dekhuijzen
P N Richard
PN
Vos
Petra J E
PJ
D018592:Cross-Over Studies; D004311:Double-Blind Method; D004417:Dyspnea / Q000188:drug therapy*; D005260:Female; D006801:Humans; D006935:Hypercapnia / Q000188:drug therapy / Q000503:physiopathology; D006993:Hypnotics and Sedatives / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D010092:Oximetry; D017286:Polysomnography; D029424:Pulmonary Disease, Chronic Obstructive / Q000188:drug therapy* / Q000503:physiopathology; D011659:Pulmonary Gas Exchange / Q000187:drug effects* / Q000502:physiology; D012891:Sleep Apnea Syndromes / Q000188:drug therapy* / Q000503:physiopathology; D013693:Temazepam / Q000627:therapeutic use*; D016896:Treatment Outcome
D006993:Hypnotics and Sedatives; D013693:Temazepam