title: Gabapentin acutely increases the apnea-hypopnea index in older men: data from a randomized, double-blind, placebo-controlled study.
abstract: Although drugs with sedative properties may increase the risk of airway collapse during sleep, their acute effects on the apnea-hypopnea index in older adults are under-reported. We investigated the acute effects of gabapentin (GABA) on sleep breathing in older men without sleep apnea. A double-blind, randomized, placebo-controlled cross-over pilot study using a bedtime dose of gabapentin 300 mg was conducted in eight non-obese older men. Polysomnography measured the effects of the intervention. The apnea-hypopnea index was higher in the gabapentin arm than in the placebo arm (22.4 ± 6.1 versus 12.2 ± 4.3, P ≤ 0.05, d: 0.67), as was the oxygen desaturation index (20.6 ± 5.8 versus 10.8 ± 3.9, P ≤ 0.05, d: 0.68). The number needed to harm was four. A subset analysis demonstrated that differences in sleep respiratory parameters were present only during non-rapid eye movement sleep, as well as only in the supine position. No adverse events were reported. Hence, gabapentin worsened sleep breathing acutely compared with placebo. Long-term clinical trials are warranted to elucidate the clinical relevance of these findings for the safety profile of GABAergic agents.
authors.affiliation: Sleep Medicine Division, Universidade Federal de São Paulo, São Paulo, Brazil.
authors.forename: Ronaldo D
authors.initials: RD
authors.lastname: Piovezan
authors.affiliation: Sleep Medicine Division, Universidade Federal de São Paulo, São Paulo, Brazil.
authors.forename: Camila
authors.initials: C
authors.lastname: Kase
authors.affiliation: Sleep Medicine Division, Universidade Federal de São Paulo, São Paulo, Brazil.
authors.forename: Renato
authors.initials: R
authors.lastname: Moizinho
authors.affiliation: Sleep Medicine Division, Universidade Federal de São Paulo, São Paulo, Brazil.
authors.forename: Sergio
authors.initials: S
authors.lastname: Tufik
authors.affiliation: Sleep Medicine Division, Universidade Federal de São Paulo, São Paulo, Brazil.
authors.forename: Dalva
authors.initials: D
authors.lastname: Poyares
mesh_terms: D000328:Adult; D000368:Aged; D000588:Amines / Q000008:administration & dosage / Q000009:adverse effects*; D000927:Anticonvulsants / Q000008:administration & dosage / Q000009:adverse effects*; D018592:Cross-Over Studies; D003509:Cyclohexanecarboxylic Acids / Q000008:administration & dosage / Q000009:adverse effects*; D004311:Double-Blind Method; D000077206:Gabapentin; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D017286:Polysomnography; D012119:Respiration / Q000187:drug effects*; D012890:Sleep / Q000187:drug effects*; D005680:gamma-Aminobutyric Acid / Q000008:administration & dosage / Q000009:adverse effects*
chemical_list: D000588:Amines; D000927:Anticonvulsants; D003509:Cyclohexanecarboxylic Acids; D006993:Hypnotics and Sedatives; D005680:gamma-Aminobutyric Acid; D000077206:Gabapentin
keywords: GABAergic agents; adverse events; apnea-hypopnea index; elderly; obstructive sleep apnea