School of Medicine and Health Sciences Poster Presentations

Title

Beneficial Effects of Oxytocin in Sleep Apnea

Document Type

Poster

Keywords

Sleep apnea treatment; intranasal oxytocin

Publication Date

Spring 2017

Abstract

Introduction: Approximately 24% of males and 9% of females in the United States suffer from obstructive sleep apnea (OSA). OSA increases cardiovascular mortality fourfold yet current treatment with continuous positive airway pressure (CPAP) only lowers arterial pressure by 2mmHg. In addition CPAP therapy is not well tolerated and as such many patients are non-adherent. This prompted further investigation into developing novel a OSA treatment. Previous research has shown oxytocin is cardioprotective, preventing the hypertension that occurs in an animal model of OSA. This study aims to test the efficacy of intranasal oxytocin administration in humans with OSA.

Methods: Eight patients diagnosed with moderate to severe OSA by a standard polysomnogram, were enrolled. These patients underwent a second polysomnogram preceded by the intranasal administration of 40 i.u. of OXT. Multiple physiological signals, including the EKG, EEG, oxyhemoglobin saturation, and respiratory airflow, were acquired by the Philips Respironics Alice 6 LDXN Sleep Diagnostic System. A registered polysomnographic technologists (RPSGT) manually scored the sleep study, identifying sleep stages, arousals, and marking the beginning and end of each apnea and hypopnea. Hypopnea is defined as reduction in ventilation of greater than 30% that results in arterial desaturation of 4% or more and lasting at least 10 seconds. Apnea is defined as a reduction in the peak signal excursion of greater than 90% and lasting at least 10 seconds.

Results:

Oxytocin increased the total sleep time from 414 minutes to 459 minutes (p<0.05). The total sleep time (TST) is the total sleep interval excluding the wake sleep stages.

Oxytocin treatment decreased the respiratory event durations from 31.7 ± 2.4 seconds to 25.8 seconds ± 1.7 seconds (mean ±S.E., p<0.05). Further stratification revealed a decrease in the hypopnea duration from 33.5 ± 2 seconds to 27.3 ± 1.6 seconds (mean ±S.E., p<0.01).

The ratio of hypopnea events that were accompanied with arousals / all hypopnea events significantly (p<0.01) decreased from 74.1 ± 3.7 % to 55.6 ± 5.3 % (mean ± S.E.). Hypopnea events that were accompanied with arousals were defined as an arousal that occurs between the start of the event and up to 5s afterwards.

Conclusion:

The administration of 40 i.u. of OXT has led to clinically significant changes in patients’ sleep physiology by increasing total sleep while decreasing both respiratory events and accompanying arousals. These changes decrease severity of OSA and it is postulated that this will precipitate a decrease in cardiovascular mortality.

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Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.

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Poster to be presented at GW Annual Research Days 2017.

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Beneficial Effects of Oxytocin in Sleep Apnea

Introduction: Approximately 24% of males and 9% of females in the United States suffer from obstructive sleep apnea (OSA). OSA increases cardiovascular mortality fourfold yet current treatment with continuous positive airway pressure (CPAP) only lowers arterial pressure by 2mmHg. In addition CPAP therapy is not well tolerated and as such many patients are non-adherent. This prompted further investigation into developing novel a OSA treatment. Previous research has shown oxytocin is cardioprotective, preventing the hypertension that occurs in an animal model of OSA. This study aims to test the efficacy of intranasal oxytocin administration in humans with OSA.

Methods: Eight patients diagnosed with moderate to severe OSA by a standard polysomnogram, were enrolled. These patients underwent a second polysomnogram preceded by the intranasal administration of 40 i.u. of OXT. Multiple physiological signals, including the EKG, EEG, oxyhemoglobin saturation, and respiratory airflow, were acquired by the Philips Respironics Alice 6 LDXN Sleep Diagnostic System. A registered polysomnographic technologists (RPSGT) manually scored the sleep study, identifying sleep stages, arousals, and marking the beginning and end of each apnea and hypopnea. Hypopnea is defined as reduction in ventilation of greater than 30% that results in arterial desaturation of 4% or more and lasting at least 10 seconds. Apnea is defined as a reduction in the peak signal excursion of greater than 90% and lasting at least 10 seconds.

Results:

Oxytocin increased the total sleep time from 414 minutes to 459 minutes (p<0.05). The total sleep time (TST) is the total sleep interval excluding the wake sleep stages.

Oxytocin treatment decreased the respiratory event durations from 31.7 ± 2.4 seconds to 25.8 seconds ± 1.7 seconds (mean ±S.E., p<0.05). Further stratification revealed a decrease in the hypopnea duration from 33.5 ± 2 seconds to 27.3 ± 1.6 seconds (mean ±S.E., p<0.01).

The ratio of hypopnea events that were accompanied with arousals / all hypopnea events significantly (p<0.01) decreased from 74.1 ± 3.7 % to 55.6 ± 5.3 % (mean ± S.E.). Hypopnea events that were accompanied with arousals were defined as an arousal that occurs between the start of the event and up to 5s afterwards.

Conclusion:

The administration of 40 i.u. of OXT has led to clinically significant changes in patients’ sleep physiology by increasing total sleep while decreasing both respiratory events and accompanying arousals. These changes decrease severity of OSA and it is postulated that this will precipitate a decrease in cardiovascular mortality.