Varenicline administration for smoking cessation may reduce apnea hypnea index in sleep apnea patients

Abstract

Background: Varenicline (VAR) is a drug used for smoking cessation. VAR administration has been reported to affect sleep.  The aim of this study was to evaluate possible polysomnographic (PSG) changes during VAR treatment (SmokeFreeBrain) in healthy smokers and smokers with obstructive sleep apnea (OSA).  Methods: 26 smokers (14 healthy and 12 with OSA) were evaluated with PSG (Embletta MPR-Master including electroencephalography (EEG), electrooculography (EOG), electromyography (EMG), electrocardiography (ECG), flow, respiration and oximetry recordings) before treatment with VAR while smoking and 20-30 days after VAR administration and smoking cessation for at least 5 days. PSGs were manually scored according to the AASM criteria.  Results: No significant differences were observed in sleep macro architecture (N1, N2, N3, REM, Sleep Efficiency, Total Sleep Time) after VAR treatment apart from prolongation of Sleep Latency (SL) N2 and N3 latency after VAR in both smokers with and without OSA. Apnea Hypopnea Index (AHI ) was reduced in OSA smokers (40.6±22.5 vs. 29.5±14.3, p=0.08) and especially during REM (42.8±22.8 vs.28.8±20.5, p=0.01) with a reduction of sleep efficiency (SE)(82.6±10.8vs.67.9±24.5, p= 0.05).  Comparing smokers with vs. without OSA, differences before and after VAR(Δ) in N3duration (-10.8±30, p=0.05), PLMI (2.86±4.4, p=0.04), arousal index (9.1±20.1, p=0.05) were found significant.

Conclusion: After VAR treatment, a reduction of AHI was observed in OSA patients with no significant alterations in sleep macro-architecture; apart from prolonged N2, N3 sleep latency and reduced SE.