Orr W C, Duke J C, Imes N K, Mellow M H
Baptist Medical Center of Oklahoma, Oklahoma City 73112.
Aliment Pharmacol Ther. 1994 Apr;8(2):203-7. doi: 10.1111/j.1365-2036.1994.tb00279.x.
Clinically, it is common for patients to experience drowsiness in association with consumption of H1-receptor antagonists. Reported side-effects with H2-receptor antagonists include insomnia and somnolence. The present study was designed to assess and compare the effects of three H2-receptor antagonists (cimetidine, famotidine, and ranitidine) on nocturnal and daytime sleepiness.
This is a double-blind crossover study on 12 normal volunteers. Subjects were studied under conditions of placebo, cimetidine (400 mg b.d.), famotidine (20 mg b.d.), and ranitidine (150 mg b.d.) for one week. Sleep was assessed at the end of each one-week interval via polysomnographic evaluation conducted on nights 6 and 7 of drug administration. On the day between the two nights in the sleep laboratory, a multiple sleep latency test was conducted.
The results revealed a significant reduction in the sleep onset latency with famotidine administration, but since there were no effects of any of the medications in the multiple sleep latency test, this finding is of dubious clinical significance. Cimetidine revealed a small increase in subjective estimates of sleepiness. No effects on sleep-related respiratory parameters were noted.
This study demonstrates the lack of effect of peripheral administration of H2-receptor antagonists on sleep stages, while subjective or objective assessment of daytime alertness revealed small effects of famotidine and cimetidine.
临床上，患者服用H1受体拮抗剂后常出现嗜睡。据报道，H2受体拮抗剂的副作用包括失眠和嗜睡。本研究旨在评估和比较三种H2受体拮抗剂（西咪替丁、法莫替丁和雷尼替丁）对夜间和白天嗜睡的影响。
这是一项针对12名正常志愿者的双盲交叉研究。受试者在安慰剂、西咪替丁（每日两次，每次400毫克）、法莫替丁（每日两次，每次20毫克）和雷尼替丁（每日两次，每次150毫克）的条件下进行为期一周的研究。在每个为期一周的间隔结束时，通过在给药的第6和第7晚进行的多导睡眠图评估来评估睡眠情况。在睡眠实验室的两个晚上之间的那天，进行多次睡眠潜伏期测试。
结果显示，服用法莫替丁后睡眠开始潜伏期显著缩短，但由于在多次睡眠潜伏期测试中任何药物均无效果，这一发现的临床意义存疑。西咪替丁显示嗜睡的主观估计略有增加。未观察到对睡眠相关呼吸参数的影响。
本研究表明，外周给予H2受体拮抗剂对睡眠阶段没有影响，而对白天警觉性的主观或客观评估显示，法莫替丁和西咪替丁有轻微影响。
