Sleep apnea in young abstinent recreational MDMA ("ecstasy") consumers.
BACKGROUND
Methylenedioxymethamphetamine (MDMA, "ecstasy") is a popular recreational drug of abuse and a selective brain serotonin neurotoxin. Functional consequences of MDMA neurotoxicity have defied ready characterization. Obstructive sleep apnea (OSA) is a common form of sleep-disordered breathing in which brain serotonin dysfunction may play a role. The present study sought to determine whether abstinent recreational MDMA users have an increased prevalence of OSA.


METHODS
We studied 71 medically healthy recreational MDMA users and 62 control subjects using all-night sleep polysomnography in a controlled inpatient research setting. Rates of apneas, hypopneas, and apnea hypopnea indices were compared in the 2 groups, controlling for body mass index, age, race, and gender.


RESULTS
Recreational MDMA users who had been drug free for at least 2 weeks had significantly increased rates of obstructive sleep apnea and hypopnea compared with controls. The odds ratio (95% confidence interval) for sleep apnea (mild, moderate, and severe combined) in MDMA users during non-REM sleep was 8.5 (2.4-30.4), which was greater than that associated with obesity [6.9 (1.7-28.2)]. Severity of OSA was significantly related to lifetime MDMA exposure.


CONCLUSIONS
These findings suggest that prior recreational methylenedioxymethamphetamine use increases the risk for obstructive sleep apnea and lend support to the notion that brain serotonin neuronal dysfunction plays a role in the pathophysiology of sleep apnea.
McCann
Una D
UD
Department of Psychiatry, The Johns Hopkins School of Medicine, Baltimore, MD 21224, USA. umccann@jhmi.edu
Sgambati
Francis P
FP
Schwartz
Alan R
AR
Ricaurte
George A
GA
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D005260:Female; D006801:Humans; D013287:Illicit Drugs / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D018817:N-Methyl-3,4-methylenedioxyamphetamine / Q000009:adverse effects; D017286:Polysomnography; D012701:Serotonin / Q000502:physiology; D012891:Sleep Apnea Syndromes / Q000209:etiology* / Q000503:physiopathology; D019966:Substance-Related Disorders / Q000150:complications* / Q000209:etiology* / Q000503:physiopathology; D055815:Young Adult
D013287:Illicit Drugs; D012701:Serotonin; D018817:N-Methyl-3,4-methylenedioxyamphetamine