Gatti Rodrigo C, Burke Patrick R, Otuyama Leonardo J, Almeida Dirceu R, Tufik Sergio, Poyares Dalva
Department of Psychobiology, Sleep Division, Universidade Federal de Sao Paulo, Brazil.
Department of Medicine, Cardiology Division, Universidade Federal de Sao Paulo, Brazil.
Sleep. 2016 Aug 1;39(8):1501-5. doi: 10.5665/sleep.6006.
This study aimed to evaluate the effects of zolpidem CR (controlled release) on sleep and nocturnal ventilation in patients with congestive heart failure, a population at risk for insomnia and poor sleep quality.
Fifteen patients with heart failure (ischemic cardiomyopathy) and ejection fraction ≤ 45% in NYHA functional class I or II were evaluated with full polysomnography in a placebo-controlled, double-blind, randomized trial. Patients underwent three tests: (1) baseline polysomnography and, after randomization, (2) a new test with zolpidem CR 12.5 mg or placebo, and after 1 week, (3) a new polysomnography, crossing the "medication" used.
A 16% increase in total sleep time was found with the use of zolpidem CR and an increase in stage 3 NREM sleep (slow wave sleep). The apnea hypopnea index (AHI) did not change with zolpidem CR even after controlling for supine position; however, a slight but significant decrease was observed in lowest oxygen saturation compared with baseline and placebo conditions (83.60 ± 5.51; 84.43 ± 3.80; 80.71 ± 5.18, P = 0.002).
Zolpidem CR improved sleep structure in patients with heart failure, did not change apnea hypopnea index, but slightly decreased lowest oxygen saturation.
本研究旨在评估缓释唑吡坦对充血性心力衰竭患者睡眠和夜间通气的影响，该类患者存在失眠和睡眠质量差的风险。
在一项安慰剂对照、双盲、随机试验中，对15例纽约心脏协会（NYHA）心功能I级或II级、射血分数≤45%的缺血性心肌病心力衰竭患者进行了全夜多导睡眠图评估。患者接受了三项测试：（1）基线多导睡眠图，随机分组后，（2）使用12.5mg缓释唑吡坦或安慰剂进行新的测试，1周后，（3）进行新的多导睡眠图测试，交叉使用“药物”。
使用缓释唑吡坦后总睡眠时间增加了16%，且3期非快速眼动睡眠（慢波睡眠）增加。即使在控制仰卧位后，缓释唑吡坦治疗后呼吸暂停低通气指数（AHI）也未改变；然而，与基线和安慰剂组相比，最低血氧饱和度出现了轻微但显著的下降（83.60±5.51；84.43±3.80；80.71±5.18，P=0.002）。
缓释唑吡坦改善了心力衰竭患者的睡眠结构，未改变呼吸暂停低通气指数，但轻微降低了最低血氧饱和度。
