Acute effects of transdermal nicotine on sleep architecture, snoring, and sleep-disordered breathing in nonsmokers.

Abstract

Previous research has suggested that nicotine may be therapeutically useful in the treatment of sleep-disordered breathing. The development of transdermal nicotine delivery systems has allowed us to test the overnight effectiveness of nicotine. Twenty nonsmoking subjects (10 men, 10 women) were recruited on the basis of a history of habitual snoring that was confirmed by overnight laboratory monitoring. Subjects were then randomized (double-blind crossover design) to receive either placebo or an active patch that delivers 11 mg of nicotine over a 24-h period. Patches were applied at 6 P.M. and removed at 6 A.M. the following morning, at which time venous blood was obtained for determination of serum nicotine concentrations. Polysomnography was performed using standard techniques to assess sleep architecture and sleep-disordered breathing. Snoring was monitored with a sound-level meter and quantitatively analyzed to determine the snoring index (SI) (number of snores per hour of sleep) and mean and maximum snoring intensities. The age of the subjects was 46.9 +/- 11.4 yr (mean +/- SD) and their mean body mass index (BMI) 33.3 +/- 4.6 kg/m2. A mean nicotine level was nondetectable with placebo and 7.8 +/- 2.3 ng/ml with wearing of an active patch. Nicotine decreased total sleep time (TST) by 33 min (p < or 0.01), sleep efficiency from 89.7 to 83.5% (p < or = 0.01), and percent rapid eye movement (REM) sleep from 18.8 to 15.1% (p < or = 0.01), and prolonged initial sleep latency (ISL) from 6.7 to 18.2 min (p < or = 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

Where There Is Smoke…There Is Sleep Apnea

“…52 Total sleep time and sleep effi ciency were decreased with the administration of nicotine. Interestingly, there was a negative correlation between serum nicotine concentration and mean duration of apnea and hypopnea events ( r 5 2 0.7, P Յ .001).…”

The Influence of a Transmucosal Cholinergic Agonist on Pharyngeal Muscle Activity

“…On the other hand, Davila and coworkers showed no effect on disordered breathing events using a nicotine transdermal patch, 16 an agent leading to high systemic nicotine levels but lower oral ones. These studies suggest that salivary levels may be important.…”

Obstructive Sleep Apnea: Part Ii. Treatment Modalities.

“…41 Transdermal nicotine patches did not influence the apnea episodes but was found to reduce the lowest oxygen saturation during sleep. 42 Modafinil may be considered as adjunctive therapy in patients who are compliant with CPAP therapy but have persistent day time sleepiness. Although, modafinil has also been shown to improve objective measures of sleepiness in untreated patients with OSA, the concern is that it may not prevent the cardiovascular consequences of OSA as it does not eliminate upper airway obstruction.…”