Effects of sildenafil on autonomic nervous function during sleep in obstructive sleep apnea

Effects of sildenafil on autonomic nervous function during sleep in obstructive sleep apnea

Autor Neves, Christiane Autor UNIFESP Google Scholar
Tufik, Sergio Autor UNIFESP Google Scholar
Chediek, Felipe Autor UNIFESP Google Scholar
Poyares, Dalva Autor UNIFESP Google Scholar
Cintra, Fátima Dumas Autor UNIFESP Google Scholar
Roizenblatt, Marina Autor UNIFESP Google Scholar
Abrantes, Fabiano Autor UNIFESP Google Scholar
Monteiro, Marina Ariza Autor UNIFESP Google Scholar
Roizenblatt, Suely Autor UNIFESP Google Scholar
Instituição Universidade Federal de São Paulo (UNIFESP)
Resumo 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.
Palavra-chave Nitric oxide
Heart rate variability
Phosphodiesterase-5
Erectile dysfunction
Oxyhemoglobin
Idioma Inglês
Financiador Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
Associação Fundo Incentivo a Psicofarmacologia (AFIP)
Data de publicação 2010-01-01
Publicado em Clinics. Faculdade de Medicina / USP, v. 65, n. 4, p. 393-400, 2010.
ISSN 1807-5932 (Sherpa/Romeo, fator de impacto)
Publicador Faculdade de Medicina / USP
Extensão 393-400
Fonte http://dx.doi.org/10.1590/S1807-59322010000400008
Direito de acesso Acesso aberto Open Access
Tipo Artigo
Web of Science WOS:000277601600008
SciELO S1807-59322010000400008 (estatísticas na SciELO)
Endereço permanente http://repositorio.unifesp.br/handle/11600/5528

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