Preview

Rational Pharmacotherapy in Cardiology

Advanced search

EFFECT OF FLUOXETINE ON SLEEP ARCHITECTURE IN PATIENTS WITH METABOLIC SYNDROME AND OBSTRUCTIVE SLEEP APNEA SYNDROME

https://doi.org/10.20996/1819-6446-2010-6-3-333-338

Full Text:

Abstract

Aim. To study effect of fluoxetine on sleep architecture in patients with metabolic syndrome and obstructive sleep apnea syndrome.

Material and methods. 98 patients with obstructive sleep apnea syndrome and metabolic syndrome (aged 54.3±8.7 y.o.) were included into the study. All patients received fluoxetine 20 mg once daily during 6 months. Influence of fluoxetine on sleep architecture was evaluated with special questionnaire and by polysomnography, including electroencephalogram, electrooculogram, mentalis electromyogram and pulseoxymetry.

Results. Decrease in wake time after sleep onset (Δ33%; р<0.05) was found at the end of treatment. It resulted in improvement of sleep efficacy index. Decrease in respiratory sleep disorders index (Δ20%) and rising of blood oxygen saturation (Δ12%; р<0.05) was also found. Improvement of the sleep architecture (reduction in the 2nd phase of slow wave sleep by 15%, increase in delta-sleep (Δ71%) and rapid eye movement sleep (Δ25%; р<0.05) was also observed. Besides reduction in body mass index after fluoxetine therapy (Δ12%; р<0.05) was found. Serious adverse effects were not registered.

Conclusion. Fluoxetine use in patients with metabolic syndrome and obstructive sleep apnea syndrome shown positive effect on objective indices of sleep architecture and respiratory sleep disorders. It improved adaptive function of the sleep and contributed to reduction in sleep disorders.

About the Authors

O. V. Lyubshina
Moscow State University of Medicine and Dentistry
Russian Federation
Delegatskaya ul. 20/1, Moscow, 127473


A. L. Vertkin
Moscow State University of Medicine and Dentistry
Russian Federation
Delegatskaya ul. 20/1, Moscow, 127473


M. Yu. Maksimova
Moscow State University of Medicine and Dentistry
Russian Federation
Delegatskaya ul. 20/1, Moscow, 127473


References

1. Gruber A., Horwood F., Sithole J. et al. Obstructive sleep apnea is independently associatedwith metabolic syndrome but notthe insulin resistance state.CardiovascDiabetol2006;5:22.

2. McArdle N., Hillman D., Beilin L., Watts G. Metabolic risk factors for vascular disease in obstructive sleep apnea. Am J Respir Crit Care Med 2007;175(2):190-5.

3. Kono M., Tatsumi K., Saibara T. et al. Obstructive sleep apnea syndrome is associated with some components of metabolic syndrome. Chest 2007;131(5):1387-92.

4. Redline S., Storfer-Isser A., Rosen C.L. et al. Association between metabolic syndrome and sleep disordered breathing in adolescents. Am J Respir Crit Care Med 2007;176(4): 401-8.

5. McNicholas W.T., Bonsigore M.R.; Management Committee of EU COST ACTION B26. Sleep apnea as an independentrisk factorfor cardiovascular disease: current evidence, basic mechanisms and research priorities. Eur Respir J 2007;29(1):156-78.

6. Vgontzas A.N., Bixler E.O., Chroussos G.P. Sleep apnea is a manifestation of the metabolic syndrome. Sleep Med Rev 2005;9(3):211-24.

7. Lavie L. Obstructive sleep apnea syndrome: an oxidative stress disorder. Sleep Med Rev 2003;7(1):35-51.

8. Suzuki Y.J., Jain V., Park A.M., Day R.M. Oxidative stress and oxidant signaling in obstructive sleep apnea and associated cardiovascular diseases. Free Radic Biol Med 2006;40(10):1683-92.

9. GozalD., Kheirandish L. Oxidant stress and inflammation in the snoring child: confluent path￾ways to upper airway pathogenesis and end organ morbidity. Sleep Med Rev 2006;10(2): 83-96.

10. Foster G.E., Poulin M.J., Hanly P.J. Intermittent hypoxia and vascular function: implications for obstructive sleep apnea. Exp Physiol 2007;92(1):51-65.

11. Gislason T., Almqvist M. Somatic diseases and sleep complaints. An epidemiological study of 3201 Swedish men. Acta Med Scand 1987;221(5):475-81.

12. Akerstedt T., Nilsson PM. Sleep as restitution: an introduction. J Intern Med 2003;254(1): 6-12.

13. Вейн А.М., Елигулашвили Т.С., Полуэктов М.Г. Синдром апноэ во сне и другие расстройства дыхания, связанные со сном: клиника, диагностика, лечение. М: Эйдос Медиа; 2002.

14. SaperJ.R., Silberstein S.D., LakeA.E 3rd, Winters ME.Double-blind trial offluoxetine: chronic daily headache and migraine. Headache 1994;34(9):497-502.

15. Goldstein D.J., Rampey A.H. Jr., Enas G.G. et al. Fluoxetine: a randomized clinical trial in the treatment of obesity. Int J Obes Relat Metab Disord 1994;18(3):129-35.

16. Prasad B., Radulovacki M., Olopade C.S. et al. Single-blind, placebo-controlled study of the efficacy and safety of ondansetron and fluoxetine in patients with obstructive sleep apnea (abstract). Am J Respir Crit Care Med 2009;179:A1257.

17. Hanzel D.A., Proia N.G., Hudgel D.W. Response of obstructive sleep apnea to fluoxetine and protriptyline. Chest 1991;100(2):416-21.

18. Kasper S., Hesselmann B., Wein W. Maintenance therapy with 20 mg fluoxetine. Results of an administration study of 1737 depressed patients (in German). Wien Klin Wochenschr 1997;109(6):197-201.

19. Левин Я.И. Инсомния: современные и диагностические подходы. М.: Медпрактика; 2005.

20. Gilaberte I., Montejo A.L., de la Gandara J. et al. Fluoxetine in the prevention of depressive recurrences: a double-blind study. J Clin Psychopharmacol 2001;21(4):417-24.

21. Newhouse P.A., Krishnan K.R., Doraiswamy P.M. et al. A double-blind comparison of sertraline and fluoxetine in depressed elderly outpatients. J Clin Psychiatry 2000;61(8):559- 68.

22. Norris S.L., Zhang X., Avenell A., et al. Pharmacotherapy for weight loss in adults with type 2 diabetes mellitus. Cochrane Database Syst Rev 2005;(1):CD004096.


For citation:


Lyubshina O.V., Vertkin A.L., Maksimova M.Yu. EFFECT OF FLUOXETINE ON SLEEP ARCHITECTURE IN PATIENTS WITH METABOLIC SYNDROME AND OBSTRUCTIVE SLEEP APNEA SYNDROME. Rational Pharmacotherapy in Cardiology. 2010;6(3):333-338. (In Russ.) https://doi.org/10.20996/1819-6446-2010-6-3-333-338

Views: 351


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


ISSN 1819-6446 (Print)
ISSN 2225-3653 (Online)