School of Psychological Sciences and Turner Institute for Brain and Mental Health, Monash University, 264 Ferntree Gully Road, Notting Hill, Victoria, 3168, Australia; Department of Pharmacology and Therapeutics, School of Biomedical Sciences, University of Melbourne, Parkville, Victoria, 3052, Australia; The Florey Institute of Neuroscience and Mental Health, The University of Melbourne, 30 Royal Parade, Parkville, Victoria, 3052, Australia.
Department of Pharmacology and Therapeutics, School of Biomedical Sciences, University of Melbourne, Parkville, Victoria, 3052, Australia; The Florey Institute of Neuroscience and Mental Health, The University of Melbourne, 30 Royal Parade, Parkville, Victoria, 3052, Australia.
Sleep Med Rev. 2020 Oct;53:101332. doi: 10.1016/j.smrv.2020.101332. Epub 2020 May 13.
Orexin receptor antagonists are a relatively new hypnotic principle. Their influence on human sleep architecture is a point of debate that has not been systematically evaluated. Thus, we performed a systematic review to assess how these compounds effect sleep architecture in healthy and clinical human samples. Relevant articles were identified via searches of PubMed, Embase, the Cochrane central register of controlled trials, and clinicaltrials. gov. From 1147 retrieved records, 18 satisfied inclusion criteria and formed the basis of this review. Of these, fifteen studies administered dual orexin receptor antagonists (DORA) in a healthy control (five studies) or clinical sample (ten studies). By contrast, three studies administered selective orexin receptor-2 antagonists (2-SORA) in either a healthy control (one study) or clinical sample (two studies). Results reveal DORAs increase total sleep time primarily by promoting REM sleep, without affecting, or even decreasing, non-REM sleep, especially in clinical samples. Therefore, the clinical utility of DORAs may depend on the specific sample being treated. For 2-SORAs, limited evidence available precludes firm conclusions about their influence on human sleep architecture and, thus, further investigation of 2-SORAs is required to define their effects and make comparisons on this basis with DORAs.
食欲素受体拮抗剂是一种相对较新的催眠原理。它们对人类睡眠结构的影响是一个有争议的问题，尚未得到系统评估。因此，我们进行了一项系统评价，以评估这些化合物如何影响健康和临床人类样本中的睡眠结构。通过对 PubMed、Embase、Cochrane 对照试验中心注册库和 clinicaltrials.gov 的搜索，确定了相关文章。从 1147 条检索记录中，有 18 条符合纳入标准，并构成了本综述的基础。其中，十五项研究在健康对照组（五项研究）或临床样本（十项研究）中给予双重食欲素受体拮抗剂（DORA）。相比之下，三项研究在健康对照组（一项研究）或临床样本（两项研究）中给予选择性食欲素受体-2 拮抗剂（2-SORA）。结果表明，DORAs 主要通过促进 REM 睡眠来增加总睡眠时间，而不影响甚至减少非 REM 睡眠，尤其是在临床样本中。因此，DORAs 的临床应用可能取决于所治疗的特定样本。对于 2-SORAs，现有证据有限，无法就其对人类睡眠结构的影响得出明确结论，因此需要进一步研究 2-SORAs，以确定其影响，并在此基础上与 DORAs 进行比较。
