TY - JOUR T1 - Effects of 1-month of zopiclone on OSA severity & symptoms: A randomised controlled trial JF - European Respiratory Journal JO - Eur Respir J DO - 10.1183/13993003.00149-2018 SP - 1800149 AU - Sophie G. Carter AU - Jayne C. Carberry AU - Garry Cho AU - Lauren P. Fisher AU - Charlotte M. Rollo AU - David J. Stevens AU - Angela L. D'Rozario AU - David K. McKenzie AU - Ronald R. Grunstein AU - Danny J. Eckert Y1 - 2018/01/01 UR - http://erj.ersjournals.com/content/early/2018/05/24/13993003.00149-2018.abstract N2 - Hypnotic use in obstructive sleep apnoea (OSA) is contraindicated due to safety concerns. Recent studies indicate that single-night hypnotic use worsens hypoxaemia in some and reduces OSA severity in others depending on differences in pathophysiology. However, longer clinical trial data is lacking. This study aimed to determine the effects of 1-month of zopiclone on OSA severity, sleepiness and alertness in patients with low-moderate respiratory arousal thresholds without major overnight hypoxaemia.69 participants completed a physiology screening night with an epiglottic catheter to quantify arousal threshold. 30 eligible patients (AHI=22±11 events/h) then completed standard in-laboratory polysomnography (baseline) and returned for two additional overnight sleep studies (nights 1 and 30) after receiving either nightly zopiclone (7.5 mg) or placebo during a 1-month, double-blind, randomised, parallel trial (ANZCTRN12613001106729).The change in AHI from baseline to night 30 was not different between zopiclone versus placebo (−5.9±10.2 vs. −2.4±5.5 events/h, p=0.24). Similarly, hypoxaemia, next-day sleepiness and driving simulator performance were not different.1-month of zopiclone does not worsen OSA severity, sleepiness or alertness in selected patients without major overnight hypoxaemia. As the first study to assess the effect of a hypnotic on OSA severity and sleepiness beyond single-night studies, these findings provide important safety data and insight into OSA pathophysiology.1-month of nightly zopiclone does not worsen OSA severity or symptoms in people with low-moderate arousal thresholdsFootnotesThis manuscript has recently been accepted for publication in the European Respiratory Journal. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJ online. Please open or download the PDF to view this article.Conflict of interest: Dr. Carter reports grants from National Health and Medical Research Council (NHMRC), grants from NeuroSleep, a NHMRC Centre for Research Excellence, personal fees from NeuroSleep, a NHMRC Centre for Research Excellence, personal fees from Neuroscience Research Australia, during the conduct of the study; personal fees from ResSleep, outside the submitted work.Conflict of interest: Dr. Carberry reports grants from National Health and Medical Research Council (NHMRC), grants from NeuroSleep, a NHMRC Centre for Research Excellence, during the conduct of the study.Conflict of interest: Dr. Cho reports grants from National Health and Medical Research Council (NHMRC), grants from NeuroSleep, a NHMRC Centre for Research Excellence, during the conduct of the study.Conflict of interest: Dr. Fisher reports grants from National Health and Medical Research Council (NHMRC), grants from NeuroSleep, a NHMRC Centre for Research Excellence, during the conduct of the study.Conflict of interest: Dr. Rollo reports grants from National Health and Medical Research Council (NHMRC), grants from NeuroSleep, a NHMRC Centre for Research Excellence, during the conduct of the study.Conflict of interest: Dr. Stevens reports grants from National Health and Medical Research Council (NHMRC), grants from NeuroSleep, a NHMRC Centre for Research Excellence, during the conduct of the study.Conflict of interest: Dr. McKenzie has nothing to disclose.Conflict of interest: Dr. Grunstein reports grants from National Health and Medical Research Council (NHMRC), grants from NeuroSleep, a NHMRC Centre for Research Excellence, during the conduct of the study; personal fees from Merck, personal fees from TEVA, outside the submitted work.Conflict of interest: Dr. Eckert reports grants from National Health and Medical Research Council (NHMRC), grants from NeuroSleep, a NHMRC Centre for Research Excellence, grants from National Health and Medical Research Council (NHMRC), during the conduct of the study; grants from Commonwealth Government of Australia Cooperative Research Centre Grant (Industry partner Oventus Medical) , personal fees from Bayer, outside the submitted work.Conflict of interest: Dr. D'Rozario reports grants from National Health and Medical Research Council (NHMRC), grants from NeuroSleep, a NHMRC Centre for Research Excellence, during the conduct of the study. ER -