Trazodone Effects on Obstructive Sleep Apnea and Non-REM Arousal Threshold

Area of Science:

• Sleep Medicine
• Respiratory Physiology
• Pharmacology

Background:

• Obstructive sleep apnea (OSA) is linked to a low respiratory arousal threshold.
• Trazodone's potential to increase arousal threshold without impacting upper airway muscles may benefit OSA patients.

Purpose of the Study:

• To investigate the effects of trazodone on OSA severity and arousal threshold.
• To test the hypothesis that trazodone increases arousal threshold and improves the apnea/hypopnea index (AHI).

Main Methods:

• A randomized crossover design study involving 15 OSA patients.
• Polysomnography with an epiglottic catheter to measure arousal threshold.
• Comparison of trazodone (100 mg) versus placebo over two nights with a one-week interval.

Main Results:

• Trazodone significantly reduced the AHI (38.7 to 28.5 events/h, P=0.041) compared to placebo.
• No significant change in non-REM arousal threshold was observed with trazodone.
• Responders to trazodone showed reduced N1 sleep and arousal index, while non-responders did not.

Conclusions:

• Trazodone may be an effective treatment for OSA patients, improving AHI without worsening hypoxemia.
• Further research into mechanisms and combination therapies is warranted to fully address OSA.
• Clinical trial registered with www.clinicaltrials.gov (NCT 01817907).