McCann Una D, Sgambati Francis P, Schwartz Alan R, Ricaurte George A
Department of Psychiatry, The Johns Hopkins School of Medicine, Baltimore, MD 21224, USA.
Neurology. 2009 Dec 8;73(23):2011-7. doi: 10.1212/WNL.0b013e3181c51a62. Epub 2009 Dec 2.
Methylenedioxymethamphetamine (MDMA, "ecstasy") is a popular recreational drug of abuse and a selective brain serotonin neurotoxin. Functional consequences of MDMA neurotoxicity have defied ready characterization. Obstructive sleep apnea (OSA) is a common form of sleep-disordered breathing in which brain serotonin dysfunction may play a role. The present study sought to determine whether abstinent recreational MDMA users have an increased prevalence of OSA.
We studied 71 medically healthy recreational MDMA users and 62 control subjects using all-night sleep polysomnography in a controlled inpatient research setting. Rates of apneas, hypopneas, and apnea hypopnea indices were compared in the 2 groups, controlling for body mass index, age, race, and gender.
Recreational MDMA users who had been drug free for at least 2 weeks had significantly increased rates of obstructive sleep apnea and hypopnea compared with controls. The odds ratio (95% confidence interval) for sleep apnea (mild, moderate, and severe combined) in MDMA users during non-REM sleep was 8.5 (2.4-30.4), which was greater than that associated with obesity [6.9 (1.7-28.2)]. Severity of OSA was significantly related to lifetime MDMA exposure.
These findings suggest that prior recreational methylenedioxymethamphetamine use increases the risk for obstructive sleep apnea and lend support to the notion that brain serotonin neuronal dysfunction plays a role in the pathophysiology of sleep apnea.
亚甲二氧基甲基苯丙胺（摇头丸，“迷魂药”）是一种广受欢迎的滥用娱乐性药物，也是一种选择性脑血清素神经毒素。摇头丸神经毒性的功能后果难以确切描述。阻塞性睡眠呼吸暂停（OSA）是睡眠呼吸障碍的一种常见形式，其中脑血清素功能障碍可能起作用。本研究旨在确定戒除娱乐性摇头丸使用者的阻塞性睡眠呼吸暂停患病率是否增加。
我们在受控的住院研究环境中，使用整夜睡眠多导睡眠图对71名身体健康的娱乐性摇头丸使用者和62名对照受试者进行了研究。比较了两组的呼吸暂停、呼吸不足和呼吸暂停低通气指数发生率，并对体重指数、年龄、种族和性别进行了控制。
与对照组相比，至少戒毒2周的娱乐性摇头丸使用者的阻塞性睡眠呼吸暂停和呼吸不足发生率显著增加。摇头丸使用者在非快速眼动睡眠期间发生睡眠呼吸暂停（轻度、中度和重度合并）的优势比（95%置信区间）为8.5（2.4 - 30.4），高于与肥胖相关的优势比[6.9（1.7 - 28.2）]。阻塞性睡眠呼吸暂停的严重程度与终身摇头丸暴露量显著相关。
这些发现表明，既往使用娱乐性亚甲二氧基甲基苯丙胺会增加阻塞性睡眠呼吸暂停的风险，并支持脑血清素神经元功能障碍在睡眠呼吸暂停病理生理学中起作用的观点。
