Evidence map›Paper›PMID 21269278›Full record

Trial reportClinical science (London, England : 1979)2011

Eszopiclone increases the respiratory arousal threshold and lowers the apnoea/hypopnoea index in obstructive sleep apnoea patients with a low arousal threshold.

Danny J Eckert, Robert L Owens, Geoffrey B Kehlmann, Andrew Wellman, Shilpa Rahangdale, Susie Yim-Yeh, David P White, Atul Malhotra

3 registry-linked trialsOpen access · greenAbstract readClinical Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Clinical science (London, England : 1979), 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 3 registered trials, which are not on this map. Cited by 175 papers, 7 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
175citing papers in PubMed, 7 pooled it
11.4field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT01102270 early_phase1completednot on this map

A Double-Blind Randomized Physiological Study Examining the Effects of Eszopiclone on the Arousal Threshold and Obstructive Sleep Apnea Severity

TypeinterventionalSponsorBrigham and Women's HospitalRan2009 to 2010Enrolled17ConditionsObstructive Sleep ApneaArmsEszopiclone, Placebo
NCT05303935 phase2completednot on this mapstarted 2022, after this paper: background citation

Effects of Quetiapine on Sleep and Next Day Alertness in People With Obstructive Sleep Apnea

TypeinterventionalSponsorFlinders UniversityRan2022 to 2023Enrolled15ConditionsSleep Apnea, ObstructiveArmsQuetiapine 50 MG, Placebo
NCT06928766 phase2not yet recruitingnot on this mapstarted 2025, after this paper: background citation

Effects of Eszopiclone and Lemborexant in People With Obstructive Sleep Apnoea (OSA) With a Low Arousal Threshold Who Have Difficulty Maintaining or Falling Asleep (ELOSA): A Double-blind, Placebo-controlled, Randomised, Trial.

TypeinterventionalSponsorFlinders UniversityRan2025 to 2027Enrolled15ConditionsOSA - Obstructive Sleep ApneaArmsEszopiclone 3 mg, Placebo, Lemborexant 10mg
3 · Its place in the literature

Who cites it

175 citing papers in PubMed, 7 syntheses or guidelines pooled it, 352 citations in OpenAlex.

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  3. Hypnotics on Obstructive Sleep Apnea Severity and Endotypes: A Systematic Review and Meta-Analysis.American journal of respiratory and critical care medicine · 2024
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  5. Eszopiclone for insomnia.The Cochrane database of systematic reviews · 2018
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  7. Drug therapy for obstructive sleep apnoea in adults.The Cochrane database of systematic reviews · 2013
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115 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 1 institution in 1 country.

Danny J EckertSleep Disorders Program, Division of Sleep Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA 02115, USA. deckert@rics.bwh.harvard.edu
Robert L Owens
Geoffrey B Kehlmann
Andrew Wellman
Shilpa Rahangdale
Susie Yim-Yeh
David P White
Atul Malhotra
Brigham and Women's Hospital · US

Funding

Wakefulness and Forebrain Activation by Orexin NeuronsP01HL095491 · NHLBI · BETH ISRAEL DEACONESS MEDICAL CENTER · PI SCAMMELL, THOMAS E · 2010 to 2019
$25.1M
Single Motor Unit Genioglossus Recordings to Understand Sleep Apnea PathogenesisR01HL085188 · NHLBI · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI MALHOTRA, ATUL · 2008 to 2018
$3.5M
Mechanisms Underlying the Aging Predisposition to Obstructive Sleep ApneaR01HL090897 · NHLBI · BRIGHAM AND WOMEN'S HOSPITAL · PI MALHOTRA, ATUL · 2009 to 2012
$1.8M
Sleep Apnea and Obesity: Cardiovascular Risk AssessmentR01HL073146 · NHLBI · BRIGHAM AND WOMEN'S HOSPITAL · PI MALHOTRA, ATUL · 2003 to 2008
$1.6M
Assessment of Upper Airway Mechanics Using Newer EMG TechniquesK24HL093218 · NHLBI · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI MALHOTRA, ATUL · 2009 to 2013
$857k
NHLBI NIH HHS HL73146NHLBI NIH HHS K24 HL093218NHLBI NIH HHS K24 HL093218-01 A1NHLBI NIH HHS P01 HL095491NHLBI NIH HHS P01 HL095491-01 A1NHLBI NIH HHS R01 HL085188NHLBI NIH HHS R01 HL085188-01A2NHLBI NIH HHS R01 HL090897NHLBI NIH HHS R01 HL090897-01A2
6 · The paper itself

Abstract

Recent insights into sleep apnoea pathogenesis reveal that a low respiratory arousal threshold (awaken easily) is important for many patients. As most patients experience stable breathing periods mediated by upper-airway dilator muscle activation via accumulation of respiratory stimuli, premature awakening may prevent respiratory stimuli build up as well as the resulting stabilization of sleep and breathing. The aim of the present physiological study was to determine the effects of a non-benzodiazepine sedative, eszopiclone, on the arousal threshold and the AHI (apnoea/hypopnoea index) in obstructive sleep apnoea patients. We hypothesized that eszopiclone would increase the arousal threshold and lower the AHI in patients with a low arousal threshold (0 to -15 cm H(2)O). Following a baseline overnight polysomnogram with an epiglottic pressure catheter to quantify the arousal threshold, 17 obstructive sleep apnoea patients, without major hypoxaemia [nadir SaO(2) (arterial blood oxygen saturation) >70%], returned on two additional nights and received 3 mg of eszopiclone or placebo immediately prior to each study. Compared with placebo, eszopiclone significantly increased the arousal threshold [-14.0 (-19.9 to -10.9) compared with -18.0 (-22.2 to -15.1) cm H(2)O; P<0.01], and sleep duration, improved sleep quality and lowered the AHI without respiratory event prolongation or worsening hypoxaemia. Among the eight patients identified as having a low arousal threshold, reductions in the AHI occurred invariably and were most pronounced (25±6 compared with 14±4 events/h of sleep; P<0.01). In conclusion, eszopiclone increases the arousal threshold and lowers the AHI in obstructive sleep apnoea patients that do not have marked overnight hypoxaemia. The greatest reductions in the AHI occurred in those with a low arousal threshold. The results of this single night physiological study suggest that certain sedatives may be of therapeutic benefit for a definable subgroup of patients. However, additional treatment strategies are probably required to achieve elimination of apnoea.

Indexed as

AdultArousalAzabicyclo CompoundsDouble-Blind MethodEszopicloneHumansHypnotics and SedativesPiperazinesRespirationSleep Apnea, ObstructiveAzabicyclo CompoundsEszopicloneHypnotics and SedativesPiperazines

Identifiers

PMID21269278
PMCPMC3415379
OpenAlexW1974089925

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.