Lettieri Christopher J, Quast Timothy N, Eliasson Arn H, Andrada Teotimo
Pulmonary and Critical Care Medicine, Walter Reed Army Medical Center, Washington, DC 20307, USA.
Sleep. 2008 Sep;31(9):1310-6.
To assess whether premedication with eszopiclone would improve sleep duration and continuity during polysomnography, thereby improving the quality of diagnostic and CPAP titration studies.
Prospective, double-blinded, placebo-controlled trial
Academic, multidisciplinary sleep center.
226 adult subjects undergoing polysomnography for suspected sleep disordered breathing; 113 received eszopiclone and 113 received placebo.
Subjects received eszopiclone 3 mg or matching placebo before polysomnography. We compared sleep latency, efficiency, total sleep time, and apnea-hypopnea index between these groups. We also compared rates of inadequate studies, defined as insufficient sleep time (< 120 min or sleep efficiency < or = 70%) or incomplete CPAP titrations (> or = 5 events/h on the highest CPAP or complete intolerance).
Eszopiclone premedication significantly improved a number of measured variables. Eszopiclone reduced sleep latency (21.7 +/- 27.1 vs. 32.6 +/- 38.2 min, P = 0.014), improved sleep efficiency (87.6% +/- 10.8% vs. 78.1% +/- 15.6%, P < 0.001), reduced wake after sleep onset (39.2 +/- 31.9 vs. 64.5 +/- 45.4 min, P <0.001) and prolonged sleep time (346.5 +/- 53.1 vs. 312.2 +/- 64.2 min, P < 0.001). Sleep efficiencies < or = 70% were more common with placebo than medication (21.2% vs. 7.1%, P = 0.004). Eszopiclone facilitated improved CPAP titrations with fewer residual events (5.7 +/- 10.3 vs. 11.9 +/- 19.6, P = 0.02) and fewer incomplete titrations (31.1% vs. 48.0%, P = 0.04). Poor quality studies (46.0% vs. 26.5%, P = 0.004) were more common with placebo than with eszopiclone. There was a trend for more non-usable studies with placebo (7.1% vs. 2.7%, P = 0.22). Side effects were uncommon and did not differ between groups.
Pretreatment with eszopiclone improves the quality of polysomnography and CPAP titration and decreases the need to repeat studies. Given the ever-growing demand for polysomnography and the need to improve efficiency, the routine use of nonbenzodiazepines as premedication for polysomnography should be considered.
评估使用艾司佐匹克隆进行预处理是否会改善多导睡眠图监测期间的睡眠时间和连续性，从而提高诊断性及持续气道正压通气（CPAP）滴定研究的质量。
前瞻性、双盲、安慰剂对照试验
学术性多学科睡眠中心
226名因疑似睡眠呼吸障碍接受多导睡眠图监测的成年受试者；113名接受艾司佐匹克隆治疗，113名接受安慰剂治疗。
受试者在多导睡眠图监测前接受3毫克艾司佐匹克隆或匹配的安慰剂。我们比较了两组之间的入睡潜伏期、睡眠效率、总睡眠时间和呼吸暂停低通气指数。我们还比较了研究不充分的发生率，定义为睡眠时间不足（<120分钟或睡眠效率≤70%）或CPAP滴定不完整（最高CPAP水平时≥5次事件/小时或完全不耐受）。
艾司佐匹克隆预处理显著改善了多个测量变量。艾司佐匹克隆缩短了入睡潜伏期（21.7±27.1分钟对32.6±38.2分钟，P = 0.014），提高了睡眠效率（87.6%±10.8%对78.1%±15.6%，P<0.001），减少了睡眠中觉醒时间（39.2±31.9分钟对64.5±45.4分钟，P<0.001）并延长了睡眠时间（346.5±53.1分钟对312.2±64.2分钟，P<0.001）。睡眠效率≤70%在安慰剂组比药物组更常见（21.2%对7.1%，P = 0.004）。艾司佐匹克隆有助于改善CPAP滴定，残余事件更少（5.7±10.3对11.9±19.6，P = 0.02）且滴定不完整的情况更少（31.1%对48.0%，P = 0.04）。质量差的研究（46.0%对26.5%，P = 0.004）在安慰剂组比艾司佐匹克隆组更常见。安慰剂组有更多不可用研究的趋势（7.1%对2.7%，P = 0.22）。副作用不常见，且两组之间无差异。
艾司佐匹克隆预处理可提高多导睡眠图和CPAP滴定的质量，并减少重复研究的需求。鉴于对多导睡眠图的需求不断增长以及提高效率的必要性，应考虑将非苯二氮䓬类药物常规用作多导睡眠图的预处理药物。
