The effects of protriptyline in sleep-disordered breathing.
The effects of protriptyline in sleep-disordered breathing.
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普罗替林对睡眠呼吸障碍的影响。
DOI：
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发表时间：
1983
期刊：
影响因子：
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通讯作者：
E. Bleecker
中科院分区：
文献类型：
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作者：
Philip L. Smith;E. Haponik;R. P. Allen;E. Bleecker
观察三环类抗抑郁药普罗替林对12例高睡眠和中重度睡眠呼吸暂停患者的治疗效果。治疗后，非快速眼动睡眠期间睡眠障碍呼吸(SDB)的持续时间或频率没有显著变化，但呼吸模式发生了变化，其特征是在SDB事件中呼吸暂停的数量减少。呼吸暂停占呼吸紊乱时间的百分比从60.4+/-27.2%下降到35.5+/-26.7%(p<0.01)，并伴有血氧饱和度峰值下降从16.2+/-6.2%下降到9.2+/-4.7%(p<0.01)。在REM睡眠期间，SDB的模式、持续时间或频率没有改变，血氧饱和度的峰值下降也没有减少。然而，阶段REM睡眠的数量减少，从而减少了更严重的SDB事件(p<0.01)，并进一步改善了夜间氧合。在12名患者中，有10名患者的日间睡眠过多有主观改善，这与中位睡眠开始时间从3.3+/-2.2分钟增加到5.1+/-2.1分钟有关(P<0.01)。虽然所有患者都出现了轻微的副作用，表现为口干，但有4名患者注意到其他副作用，包括尿液迟疑、轻度便秘和难以维持勃起。一名患者出现了无法忍受的便秘，需要停药。我们的结论是，普曲替林可减少白天高睡眠，改变SDB的模式，从而改善睡眠中的气体交换和氧合。因此，在选定的中度重度阻塞性睡眠呼吸暂停患者中，丙替林治疗是气管切开术手术治疗的替代方案。
The effects of therapy with the tricyclic antidepressant protriptyline were studied in 12 patients with hypersomnolence and moderately severe sleep apnea. After treatment there was no significant change in the duration or frequency of sleep-disordered breathing (SDB) during non-REM sleep, but there was an alteration in the breathing pattern characterized by a decrease in the amount of apnea during SDB events. Apnea, as a percent of disordered breathing time, fell from 60.4 +/- 27.2% to 35.5 +/- 26.7% (p less than 0.01) and was accompanied by a reduction in the peak fall in oxygen saturation from 16.2 +/- 6.2% to 9.2 +/- 4.7% (p less than 0.01). During REM sleep there was no change in the pattern, duration, or frequency of SDB, or reduction in the peak fall in oxygen saturation. However, there was a reduction in the amount of Stage REM sleep, thereby reducing the more severe SDB events (p less than 0.01) and further improving nocturnal oxygenation. In 10 of 12 patients, there was subjective improvement in daytime hypersomnolence, which was associated with an increase in median sleep onset time from 3.3 +/- 2.2 to 5.1 +/- 2.1 min (p less than 0.01). Although all patients developed mild side effects from the anticholinergic properties of protriptyline manifested by a dry mouth, 4 patients noted additional side effects including urinary hesitancy, mild constipation, and difficulty in maintaining an erection. One patient developed intolerable constipation that necessitated discontinuation of the drug. We conclude that protriptyline reduced daytime hypersomnolence and altered the pattern of SDB, thus improving gas exchange and oxygenation during sleep. Therefore, in selected patients with moderately severe obstructive sleep apnea, therapy with protriptyline is an alternative to surgical treatment with a tracheostomy.