Study Objectives: Drug-induced sleep endoscopy (DISE) using propofol is commonly used to identify the pharyngeal structure involved in collapse among patients with obstructive sleep apnea. DISE has never been compared with zolpidem-induced sleep endoscopy. We hypothesized that propofol at recommended sedation levels does not influence upper airway collapsibility nor the frequency of multilevel pharyngeal collapse as compared with zolpidem-induced sleep.
Methods: Twenty-one patients with obstructive sleep apnea underwent polysomnography and sleep endoscopy during zolpidem-induced sleep and during DISE with propofol. A propofol target-controlled infusion was titrated to achieve a bispectral index between 50 and 70. Airway collapsibility was estimated and compared in both conditions by peak inspiratory flow and the magnitude of negative effort dependence. Respiratory drive was estimated by the difference between end-expiratory and peak-negative inspiratory pharyngeal pressure (driving pressure). Site and configuration of pharyngeal collapse during zolpidem-induced sleep and DISE with propofol were compared.
Results: The frequency of multilevel collapse during zolpidem-induced sleep was similar to that observed during DISE with propofol (72% vs 86%, respectively; difference: 14%; 95% confidence interval: -12% to 40%; P = .453). The endoscopic classification of pharyngeal collapse during both conditions were similar. Peak inspiratory flow, respiratory drive (effect size: 0.05 and 0.03, respectively), and negative effort dependence (difference: -6%; 95% confidence interval: -16% to 4%) were also similar in both procedures.
Conclusions: In this pilot study, recommended propofol doses did not significantly increase multilevel pharyngeal collapse or affect upper airway collapsibility and respiratory drive as compared with zolpidem-induced sleep.
Clinical Trial Registration: Registry: clinicaltrials.gov; Name: Natural and Drug Sleep Endoscopy; URL: https://clinicaltrials.gov/ct2/show/study/NCT03004014; Identifier: NCT03004014.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7849792 | PMC |
| http://dx.doi.org/10.5664/jcsm.8334 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Deep brain stimulation of the central thalamus restores arousal and motivation in a zolpidem-responsive patient with akinetic mutism after severe brain injury.
Sci Rep
February 2024
Department of Neurosurgery, Amsterdam Neuroscience, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.
Article Synopsis
- Zolpidem can trigger brief and impressive improvements in brain functions for some patients with severe brain injury, especially when paired with deep brain stimulation (DBS).
- This study focused on a patient whose motivation and arousal were improved through DBS treatment targeting a specific brain area, resulting in significant functional gains like communication and mobility.
- Findings showed that DBS reduces excessive brain connectivity, suggesting that less connectivity could enhance cognitive function post-injury, providing insights for future therapies.
Zolpidem for Insomnia: A Double-Edged Sword. A Systematic Literature Review on Zolpidem-Induced Complex Sleep Behaviors.
Indian J Psychol Med
September 2021
Dept. of Pharmacology, Pandit Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences, Rohtak, Haryana, India.
Background: Being a nonbenzodiazepine, zolpidem is believed to have a favorable side-effect profile and is widely prescribed for insomnia. However, in the past few years, numerous neuropsychiatric adverse reactions, particularly complex sleep behaviors (CSBs), have been reported with zolpidem.
Objective: To conduct a systematic review of zolpidem-associated CSBs.
Awakening after a sleeping pill: Restoring functional brain networks after severe brain injury.
Cortex
November 2020
Amsterdam UMC, University of Amsterdam, Department of Neurosurgery, Amsterdam Neuroscience, Amsterdam, the Netherlands.
Article Synopsis
- * This study utilized advanced imaging techniques (electroencephalography and magnetoencephalography) to analyze a significant recovery in a patient with severe brain damage, revealing that these improvements were linked to changes in brain connectivity, specifically in beta band rhythms.
- * The findings suggest that enhanced beta band connectivity is important for cognitive function and goal-directed behavior, pointing to the need for more research into the relationship between beta rhythms and neurological recovery following severe brain injuries.
Comparison of upper airway obstruction during zolpidem-induced sleep and propofol-induced sleep in patients with obstructive sleep apnea: a pilot study.
J Clin Sleep Med
May 2020
Pulmonary Division, Heart Institute (InCor), Universidade de São Paulo, São Paulo, Brazil.
Study Objectives: Drug-induced sleep endoscopy (DISE) using propofol is commonly used to identify the pharyngeal structure involved in collapse among patients with obstructive sleep apnea. DISE has never been compared with zolpidem-induced sleep endoscopy. We hypothesized that propofol at recommended sedation levels does not influence upper airway collapsibility nor the frequency of multilevel pharyngeal collapse as compared with zolpidem-induced sleep.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!