RB Berry, K Kouchi, J Bower, G Prosise and RW Light
Department of Medicine, Long Beach Veterans Administration Medical Center, CA 90822.

The purpose of this study was to assess the effect of triazolam (0.25 mg) on apnea duration and the arousal response to airway occlusion during sleep in patients with severe obstructive sleep apnea (OSA). Twelve male subjects with a mean (+/- SD) age of 46.6 +/- 14.1 yr and body weight of 260.8 +/- 55.9 lb were studied on two nights separated by a nonstudy night. They ingested triazolam (0.25 mg) or placebo 0.5 h before bedtime in a randomized double-blind crossover manner. In non- rapid-eye-movement (NREM) sleep, the mean (+/- SEM) duration of apnea/hypopnea was slightly increased (26.8 +/- 1.7 versus 23.8 +/- 1.2 s, p < 0.02) and the mean nadir in arterial oxygen saturation lower (80.1 +/- 1.9 versus 84.2 +/- 1.4%, p < 0.001) on triazolam nights. In NREM sleep, the deflections in esophageal pressure prior to apnea termination were higher on triazolam nights (53.3 +/- 5.4 versus 44.5 +/- 4.8 cm H2O, p < 0.001). However, the rate of increase in inspiratory effort (esophageal pressure deflections) during obstructive events was not decreased by triazolam. We conclude that triazolam increases the arousal threshold to airway occlusion, but that this results in only modest prolongation of event duration and increased desaturation at a dose of 0.25 mg in a group of large sleep apnea patients.

This article has been cited by other articles:

				M. Younes, M. Ostrowski, R. Atkar, J. Laprairie, A. Siemens, and P. Hanly Mechanisms of breathing instability in patients with obstructive sleep apnea J Appl Physiol, December 1, 2007; 103(6): 1929 - 1941. [Abstract] [Full Text] [PDF]

				M. Eikermann, A. S. Jordan, N. L. Chamberlin, S. Gautam, A. Wellman, Y.-L. Lo, D. P. White, and A. Malhotra The Influence of Aging on Pharyngeal Collapsibility During Sleep Chest, June 1, 2007; 131(6): 1702 - 1709. [Abstract] [Full Text] [PDF]

				M. Younes Role of Arousals in the Pathogenesis of Obstructive Sleep Apnea Am. J. Respir. Crit. Care Med., March 1, 2004; 169(5): 623 - 633. [Abstract] [Full Text] [PDF]

				A. Malhotra, Y. Huang, R. B. Fogel, G. Pillar, J. K. Edwards, R. Kikinis, S. H. Loring, and D. P. White The Male Predisposition to Pharyngeal Collapse: Importance of Airway Length Am. J. Respir. Crit. Care Med., November 15, 2002; 166(10): 1388 - 1395. [Abstract] [Full Text] [PDF]

				W. W. Flemons Obstructive Sleep Apnea N. Engl. J. Med., August 15, 2002; 347(7): 498 - 504. [Full Text] [PDF]

				N. A. Collop Can't Sleep? : You May Have Sleep Apnea! Chest, December 1, 2001; 120(6): 1768 - 1769. [Full Text] [PDF]

				N. T. AYAS, R. BROWN, and S. A. SHEA Hypercapnia Can Induce Arousal from Sleep in the Absence of Altered Respiratory Mechanoreception Am. J. Respir. Crit. Care Med., September 1, 2000; 162(3): 1004 - 1008. [Abstract] [Full Text]

				R. B. Berry, M. A. Asyali, M. I. McNellis, and M. C. K. Khoo Within-night variation in respiratory effort preceding apnea termination and EEG delta power in sleep apnea J Appl Physiol, October 1, 1998; 85(4): 1434 - 1441. [Abstract] [Full Text] [PDF]