Jain Vivek, Kimbro Shawn, Kowalik Grant, Milojevic Ivana, Maritza Dowling N, Hunley Anne Lloyd, Hauser Kelsey, Andrade David C, Del Rio Rodrigo, Kay Matthew W, Mendelowitz David
Department of Medicine, The George Washington University, Washington, DC, USA.
Department of Biomedical Engineering, The George Washington University, Washington, DC, USA.
Sleep Med. 2020 Oct;74:242-247. doi: 10.1016/j.sleep.2020.05.034. Epub 2020 Jun 5.
Activation of the oxytocin network has shown benefits in animal models of Obstructive Sleep Apnea (OSA) as well as other cardiorespiratory diseases. We sought to determine if nocturnal intranasal oxytocin administration could have beneficial effects in reducing the duration and/or frequency of obstructive events in obstructive sleep apnea subjects.
Two sequential standard "in-lab" polysomnogram (PSG) sleep studies were performed in patients diagnosed with OSA that were randomly assigned to initially receive either placebo or oxytocin (40 i.u.) administered intranasally in this double blinded randomized placebo controlled study. Changes in cardiorespiratory events during sleep, including apnea and hypopnea durations and frequency, risk of event-associated bradycardias, arterial oxygen desaturation and respiratory rate were assessed in 2 h epochs following sleep onset. Oxytocin significantly decreased the duration of obstructive events, as well as the oxygen desaturations and incidence of bradycardia that were associated with these events. Notably, oxytocin increased respiratory rate during non-obstructive periods. There were no significant changes in sleep architecture and no adverse effects were reported.
Oxytocin administration can benefit OSA subjects by reducing the duration and adverse consequences of obstructive events. Oxytocin could also be beneficial in situations involving respiratory depression as oxytocin increased respiratory rate. Additional studies are needed to further understand the mechanisms by which oxytocin promotes these changes in cardiorespiratory function. The long-term efficacy and optimal dose of intranasal oxytocin treatment should also be determined in OSA subjects. ClinicalTrials.gov NCT03148899.
在阻塞性睡眠呼吸暂停（OSA）以及其他心肺疾病的动物模型中，催产素网络的激活已显示出有益效果。我们试图确定夜间鼻内给予催产素是否对减少阻塞性睡眠呼吸暂停患者阻塞性事件的持续时间和/或频率有有益影响。
在被诊断为OSA的患者中进行了两项连续的标准“实验室”多导睡眠图（PSG）睡眠研究，这些患者被随机分配，在这项双盲随机安慰剂对照研究中，最初接受安慰剂或鼻内给予催产素（40国际单位）。在入睡后的2小时时间段内，评估睡眠期间心肺事件的变化，包括呼吸暂停和呼吸不足的持续时间和频率、事件相关心动过缓的风险、动脉血氧饱和度下降和呼吸频率。催产素显著降低了阻塞性事件的持续时间，以及与这些事件相关的血氧饱和度下降和心动过缓的发生率。值得注意的是，催产素在非阻塞期增加了呼吸频率。睡眠结构没有显著变化，也未报告不良反应。
给予催产素可通过减少阻塞性事件的持续时间和不良后果使OSA患者受益。由于催产素增加了呼吸频率，因此在涉及呼吸抑制的情况下也可能有益。需要进一步的研究来进一步了解催产素促进心肺功能这些变化的机制。还应在OSA患者中确定鼻内催产素治疗的长期疗效和最佳剂量。ClinicalTrials.gov NCT03148899。
