Sedative Medication Use: Prevalence, Risk Factors, And Associations With Body Mass Index Using Population-Level Data

Vozoris, Nicholas T.; Leung, Richard

doi:10.1164/ajrccm-conference.2011.183.1_meetingabstracts.a5252

Cited by 12 publications

(15 citation statements)

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“…In previous cohorts of patients aged ≥65 years, and with dementia, the proportion of patients using at least one drug with an anticholinergic activity was 43–50% . In another study, the proportion of patients using sedative drugs was estimated at 9% among community‐dwelling people aged ≥60 years . It is expected that the prescription of drugs with anticholinergic and sedative effects is more related to patients whose pathologies are managed by drugs with these known effects, i.e.…”

Section: Introductionmentioning

confidence: 97%

Factors associated with changes in exposure to anticholinergic and sedative medications in elderly hospitalized patients: multicentre longitudinal study

Dauphinot

Faure

Bourguignon

et al. 2016

Euro J of Neurology

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Section: Introductionmentioning

confidence: 97%

Factors associated with changes in exposure to anticholinergic and sedative medications in elderly hospitalized patients: multicentre longitudinal study

Dauphinot

Faure

Bourguignon

et al. 2016

Euro J of Neurology

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“…In addition, sedative-induced decrements in pharyngeal dilator muscle activity also could worsen apnea. Given the high rates of sedative use in the community, particularly in the obese 16 , it is important to determine the effects of sedatives on upper airway physiology and breathing during sleep.…”

Section: Introductionmentioning

confidence: 99%

Trazodone Increases the Respiratory Arousal Threshold in Patients with Obstructive Sleep Apnea and a Low Arousal Threshold

Eckert

Malhotra

Wellman

et al. 2014

Sleep

122

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Study Objectives: The effect of common sedatives on upper airway physiology and breathing during sleep in obstructive sleep apnea (OSA) has been minimally studied. Conceptually, certain sedatives may worsen OSA in some patients. However, sleep and breathing could improve with certain sedatives in patients with OSA with a low respiratory arousal threshold. This study aimed to test the hypothesis that trazodone increases the respiratory arousal threshold in patients with OSA and a low arousal threshold. Secondary aims were to examine the effects of trazodone on upper airway dilator muscle activity, upper airway collapsibility, and breathing during sleep. Design: Patients were studied on 4 separate nights according to a within-subjects cross-over design. Setting: Sleep physiology laboratory. Patients: Seven patients with OSA and a low respiratory arousal threshold. Interventions: In-laboratory polysomnograms were obtained at baseline and after 100 mg of trazodone was administered, followed by detailed overnight physiology experiments under the same conditions. During physiology studies, continuous positive airway pressure was transiently lowered to measure arousal threshold (negative epiglottic pressure prior to arousal), dilator muscle activity (genioglossus and tensor palatini), and upper airway collapsibility (Pcrit). Measurements and Results:Trazodone increased the respiratory arousal threshold by 32 ± 6% (-11.5 ± 1.4 versus -15.3 ± 2.2 cmH 2 O, P < 0.01) but did not alter the apnea-hypopnea index (39 ± 12 versus 39 ± 11 events/h sleep, P = 0.94). Dilator muscle activity and Pcrit also did not systematically change with trazodone. Conclusions: Trazodone increases the respiratory arousal threshold in patients with obstructive sleep apnea and a low arousal threshold without major impairment in dilator muscle activity or upper airway collapsibility. However, the magnitude of change in arousal threshold was insufficient to overcome the compromised upper airway anatomy in these patients. Keywords: Arousal, lung, muscles, respiratory physiology, sedative, sleep-disordered breathing, upper airway Citation: Eckert DJ; Malhotra A; Wellman A; White DP. Trazodone increases the respiratory arousal threshold in patients with obstructive sleep apnea and a low arousal threshold. SLEEP 2014;37(4):811-819.

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“…To test whether hypnotic use was a special risk factor for the morbidly obese, as has been suggested, 26 we used a statistical test for interaction between hypnotic use and BMI of 35 or greater.…”

Section: Methodsmentioning

confidence: 99%

Cohort study of the association of hypnotic use with mortality in postmenopausal women

Hartz

Ross

2012

BMJ Open

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ObjectivePrevious studies found an association between hypnotic use and mortality risk. The prospective outcome data and the many baseline risk factors included in the Women's Health Initiative (WHI) provide an opportunity to better understand the reasons for this association.SettingThe WHI is a long-term national health study that focused on strategies for preventing disease in postmenopausal women. Participants were enrolled from 1993 to 1998.DesignBaseline hypnotic use was evaluated for an association with subsequent mortality or disease after adjusting for baseline risk.Subjects148 938 postmenopausal women between the ages of 50 and 79 throughout the USA. The median follow-up was 8 years.Main outcome measuresMortality. Secondary outcomes included myocardial infarction, stroke, diabetes and seven types of cancer.ResultsFor persons who use hypnotic medications almost daily the age-adjusted hazard ratio (HR) for mortality was 1.62 (95% CI 1.50 to 1.74). Greater hypnotic use was associated with less healthy levels of physical function, general health and smoking at baseline. After adjustment for these factors the HR for almost daily hypnotic use was 1.14 (1.06 to 1.23) for mortality and 1.53 (1.18 to 1.99) for melanoma; it was not significantly associated with increased incidence of other diseases tested. Less frequent hypnotic use and several types of sleeping difficulties were not associated with mortality, but sleeping more than 10 h a night had a risk-adjusted HR for mortality of 1.28 (1.01 to 1.61).ConclusionsThe association of hypnotic use with mortality and incident disease was greatly reduced after adjusting for baseline risk factors. These findings do not support a strong independent association of hypnotic use with most health outcomes.

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Sedative Medication Use: Prevalence, Risk Factors, And Associations With Body Mass Index Using Population-Level Data

Cited by 12 publications

References 0 publications

Factors associated with changes in exposure to anticholinergic and sedative medications in elderly hospitalized patients: multicentre longitudinal study

Factors associated with changes in exposure to anticholinergic and sedative medications in elderly hospitalized patients: multicentre longitudinal study

Trazodone Increases the Respiratory Arousal Threshold in Patients with Obstructive Sleep Apnea and a Low Arousal Threshold

Cohort study of the association of hypnotic use with mortality in postmenopausal women

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