Effects of sildenafil on autonomic nervous function during sleep in obstructive sleep apnea
OBJECTIVE: To evaluate the effects of sildenafil on the autonomic nervous system in patients with severe obstructive sleep apnea. METHODS: Thirteen male patients with severe obstructive sleep apnea (mean age 43±10 years with a mean body mass index of 26.7±1.9 kg/m²) received a single 50-mg dose of s...
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier España
2010-01-01
|
| Series: | Clinics |
| Subjects: | |
| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1807-59322010000400008 |
| _version_ | 1818246370293710848 |
|---|---|
| author | Christiane Neves Sérgio Tufik Felipe Chediek Dalva Poyares Fátima Cintra Marina Roizenblatt Fabiano Abrantes Marina Ariza Monteiro Suely Roizenblatt |
| author_facet | Christiane Neves Sérgio Tufik Felipe Chediek Dalva Poyares Fátima Cintra Marina Roizenblatt Fabiano Abrantes Marina Ariza Monteiro Suely Roizenblatt |
| author_sort | Christiane Neves |
| collection | DOAJ |
| description | OBJECTIVE: To evaluate the effects of sildenafil on the autonomic nervous system in patients with severe obstructive sleep apnea. METHODS: Thirteen male patients with severe obstructive sleep apnea (mean age 43±10 years with a mean body mass index of 26.7±1.9 kg/m²) received a single 50-mg dose of sildenafil or a placebo at bedtime. All-night polysomnography and heart rate variability were recorded. Frequency domain analysis of heart rate variability was performed for the central five-minute sample of the longest uninterrupted interval of slow wave and rapid eye movement sleep, as well as for one-minute samples during apnea and during slow wave and rapid eye movement sleep after resumption of respiration. RESULTS: Compared to the placebo, sildenafil was associated with an increase in the normalized high-frequency (HFnu) components and a decrease in the low/high-frequency components of the heart rate variability ratio (LF/HF) in slow wave sleep (p<0.01 for both). Differences in heart rate variability parameters between one-minute post-apnea and apnea samples (Δ= difference between resumption of respiration and apnea) were assessed. A trend toward a decreasing magnitude of ΔLF activity was observed during rapid eye movement sleep with sildenafil in comparison to placebo (p=0.046). Additionally, Δ LF/HF in SWS and rapid eye movement sleep was correlated with mean desaturation (sR= -0.72 and -0.51, respectively, p= 0.01 for both), and Δ HFnu in rapid eye movement sleep was correlated with mean desaturation (sR= 0.66, p= 0.02) and the desaturation index (sR= 0.58, p = 0.047). CONCLUSIONS: The decrease in arousal response to apnea/hypopnea events along with the increase in HFnu components and decrease in LH/HF components of the heart rate variability ratio during slow wave sleep suggest that, in addition to worsening sleep apnea, sildenafil has potentially immediate cardiac effects in patients with severe obstructive sleep apnea. |
| first_indexed | 2024-12-12T14:47:44Z |
| format | Article |
| id | doaj.art-b45cb217e76a446e8e6f80869d52d652 |
| institution | Directory Open Access Journal |
| issn | 1807-5932 1980-5322 |
| language | English |
| last_indexed | 2024-12-12T14:47:44Z |
| publishDate | 2010-01-01 |
| publisher | Elsevier España |
| record_format | Article |
| series | Clinics |
| spelling | doaj.art-b45cb217e76a446e8e6f80869d52d6522022-12-22T00:21:05ZengElsevier EspañaClinics1807-59321980-53222010-01-0165439340010.1590/S1807-59322010000400008Effects of sildenafil on autonomic nervous function during sleep in obstructive sleep apneaChristiane NevesSérgio TufikFelipe ChediekDalva PoyaresFátima CintraMarina RoizenblattFabiano AbrantesMarina Ariza MonteiroSuely RoizenblattOBJECTIVE: To evaluate the effects of sildenafil on the autonomic nervous system in patients with severe obstructive sleep apnea. METHODS: Thirteen male patients with severe obstructive sleep apnea (mean age 43±10 years with a mean body mass index of 26.7±1.9 kg/m²) received a single 50-mg dose of sildenafil or a placebo at bedtime. All-night polysomnography and heart rate variability were recorded. Frequency domain analysis of heart rate variability was performed for the central five-minute sample of the longest uninterrupted interval of slow wave and rapid eye movement sleep, as well as for one-minute samples during apnea and during slow wave and rapid eye movement sleep after resumption of respiration. RESULTS: Compared to the placebo, sildenafil was associated with an increase in the normalized high-frequency (HFnu) components and a decrease in the low/high-frequency components of the heart rate variability ratio (LF/HF) in slow wave sleep (p<0.01 for both). Differences in heart rate variability parameters between one-minute post-apnea and apnea samples (Δ= difference between resumption of respiration and apnea) were assessed. A trend toward a decreasing magnitude of ΔLF activity was observed during rapid eye movement sleep with sildenafil in comparison to placebo (p=0.046). Additionally, Δ LF/HF in SWS and rapid eye movement sleep was correlated with mean desaturation (sR= -0.72 and -0.51, respectively, p= 0.01 for both), and Δ HFnu in rapid eye movement sleep was correlated with mean desaturation (sR= 0.66, p= 0.02) and the desaturation index (sR= 0.58, p = 0.047). CONCLUSIONS: The decrease in arousal response to apnea/hypopnea events along with the increase in HFnu components and decrease in LH/HF components of the heart rate variability ratio during slow wave sleep suggest that, in addition to worsening sleep apnea, sildenafil has potentially immediate cardiac effects in patients with severe obstructive sleep apnea.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1807-59322010000400008Nitric oxideHeart rate variabilityPhosphodiesterase-5Erectile dysfunctionOxyhemoglobin |
| spellingShingle | Christiane Neves Sérgio Tufik Felipe Chediek Dalva Poyares Fátima Cintra Marina Roizenblatt Fabiano Abrantes Marina Ariza Monteiro Suely Roizenblatt Effects of sildenafil on autonomic nervous function during sleep in obstructive sleep apnea Clinics Nitric oxide Heart rate variability Phosphodiesterase-5 Erectile dysfunction Oxyhemoglobin |
| title | Effects of sildenafil on autonomic nervous function during sleep in obstructive sleep apnea |
| title_full | Effects of sildenafil on autonomic nervous function during sleep in obstructive sleep apnea |
| title_fullStr | Effects of sildenafil on autonomic nervous function during sleep in obstructive sleep apnea |
| title_full_unstemmed | Effects of sildenafil on autonomic nervous function during sleep in obstructive sleep apnea |
| title_short | Effects of sildenafil on autonomic nervous function during sleep in obstructive sleep apnea |
| title_sort | effects of sildenafil on autonomic nervous function during sleep in obstructive sleep apnea |
| topic | Nitric oxide Heart rate variability Phosphodiesterase-5 Erectile dysfunction Oxyhemoglobin |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1807-59322010000400008 |
| work_keys_str_mv | AT christianeneves effectsofsildenafilonautonomicnervousfunctionduringsleepinobstructivesleepapnea AT sergiotufik effectsofsildenafilonautonomicnervousfunctionduringsleepinobstructivesleepapnea AT felipechediek effectsofsildenafilonautonomicnervousfunctionduringsleepinobstructivesleepapnea AT dalvapoyares effectsofsildenafilonautonomicnervousfunctionduringsleepinobstructivesleepapnea AT fatimacintra effectsofsildenafilonautonomicnervousfunctionduringsleepinobstructivesleepapnea AT marinaroizenblatt effectsofsildenafilonautonomicnervousfunctionduringsleepinobstructivesleepapnea AT fabianoabrantes effectsofsildenafilonautonomicnervousfunctionduringsleepinobstructivesleepapnea AT marinaarizamonteiro effectsofsildenafilonautonomicnervousfunctionduringsleepinobstructivesleepapnea AT suelyroizenblatt effectsofsildenafilonautonomicnervousfunctionduringsleepinobstructivesleepapnea |