Sleep Research Laboratory, St. Vincent's University Hospital, Dublin, Ireland.
Respiration. 2010;79(6):475-81. doi: 10.1159/000235619. Epub 2009 Aug 14.
Sleep is associated with important adverse effects in patients with chronic obstructive pulmonary disease (COPD), such as disturbed sleep quality and gas exchange, including hypoxemia and hypercapnia. The effects of inhaled long-acting beta(2)-agonist therapy (LABA) on these disturbances are unclear.
The aim of the study was to assess the effect of inhaled salmeterol on nocturnal sleeping arterial oxygen saturation (SaO(2)) and sleep quality.
In a randomized, double-blind, placebo-controlled, crossover study of moderate/severe stable COPD patients, we compared the effects of 4 weeks of treatment with salmeterol 50 microg b.d. and matching placebo on sleeping SaO(2) and sleep quality. Overnight polysomnography (PSG) was performed at baseline, and after 4 and 8 weeks in addition to detailed pulmonary function testing. Of 15 patients included, 12 completed the trial (median age 69 years, forced expiratory volume in 1 s, FEV(1): 39%).
Both mean SaO(2) [salmeterol vs. placebo: 92.9% (91.2, 94.7) vs. 91.0% (88.9, 94.8); p = 0.016] and the percentage of sleep spent below 90% of SaO(2) [1.8% (0.0, 10.8) vs. 25.6% (0.5, 53.5); p = 0.005] improved significantly with salmeterol. Sleep quality was similar with both salmeterol and placebo on PSG. Static lung volumes, particularly trapped gas volume, tended to improve with salmeterol.
We conclude that inhaled LABA therapy improves sleeping SaO(2) without significant change in sleep quality.
睡眠与慢性阻塞性肺疾病（COPD）患者的许多不良后果相关，如睡眠质量下降和气体交换异常，包括低氧血症和高碳酸血症。目前尚不清楚吸入长效β2-激动剂（LABA）治疗对这些紊乱的影响。
评估沙美特罗对夜间睡眠动脉血氧饱和度（SaO2）和睡眠质量的影响。
在一项中重度稳定 COPD 患者的随机、双盲、安慰剂对照交叉研究中，我们比较了沙美特罗 50μg，每日 2 次（b.d.）和匹配安慰剂治疗 4 周对睡眠 SaO2 和睡眠质量的影响。在基线时、4 周和 8 周时进行了整夜多导睡眠图（PSG）检查，并进行了详细的肺功能检查。15 例患者中，12 例完成了试验（中位年龄 69 岁，第 1 秒用力呼气容积，FEV1：39%）。
平均 SaO2（沙美特罗与安慰剂：92.9%（91.2，94.7）与 91.0%（88.9，94.8）；p=0.016）和睡眠时 SaO2 低于 90%的时间百分比（沙美特罗与安慰剂：1.8%（0.0，10.8）与 25.6%（0.5，53.5）；p=0.005）均显著改善。PSG 上沙美特罗与安慰剂的睡眠质量相似。静态肺容积，特别是残气量，有改善趋势。
我们的结论是，吸入 LABA 治疗可改善睡眠 SaO2，而对睡眠质量无显著影响。
