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Sleep apnea: treatment with protriptyline.

R W Clark, H S Schmidt, S F Schaal

|September 1, 1979

Summary

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Protriptyline, a nonsedating antidepressant, effectively reduced upper airway obstruction episodes in sleep apnea patients. This medical therapy provided sustained control for many, suggesting pharmacologic reversal of airway incoordination.

Area of Science:

Sleep Medicine
Pharmacology
Otolaryngology

Background:

Sleep apnea involves repeated upper airway obstruction during sleep.
Pharmacological interventions are explored for managing sleep apnea.
Nonsedating tricyclic antidepressants represent a potential therapeutic avenue.

Purpose of the Study:

To evaluate the efficacy of protriptyline in treating patients with significant upper airway obstruction during sleep.
To assess the impact of protriptyline on the frequency and duration of apneas.
To determine the long-term effectiveness and safety of protriptyline for sleep apnea management.

Main Methods:

A cohort of 14 patients with frequent nocturnal airway obstruction episodes received protriptyline.
Objective measures of apnea frequency and duration were recorded.

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Patients were monitored for treatment response and adverse effects over 7 to 15 months.

Main Results:

Protriptyline decreased the frequency and duration of apneas in 11 out of 14 patients.
Eight patients achieved satisfactory sleep apnea control with protriptyline alone.
Sustained control was observed for 7 to 15 months in responders.
Cardiovascular adverse effects were noted as a potential limitation.

Conclusions:

Protriptyline demonstrates potential as a pharmacologic treatment for sleep-induced upper airway incoordination.
Medical therapy with protriptyline can achieve sustained control of sleep apnea in a subset of patients.
Careful consideration of cardiovascular side effects is necessary when using protriptyline for sleep apnea.