Evidence map›Paper›PMID 24899767›Full record

Trial reportSleep2014

Trazodone increases the respiratory arousal threshold in patients with obstructive sleep apnea and a low arousal threshold.

Danny J Eckert, Atul Malhotra, Andrew Wellman, David P White

Registry-linked trialOpen access · bronzeAbstract readClinical Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Sleep, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06928766 (Effects of Eszopiclone and Lemborexant in People With Obstructive Sleep Apnoea), which is not on this map. Cited by 75 papers.

0numbers the graph read from it
0cells of the map it votes in
75citing papers in PubMed
6.9field-weighted citation impact, top 2% 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.

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

75 citing papers in PubMed, 150 citations in OpenAlex.

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15 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

4 authors at 2 institutions in 2 countries.

Danny J EckertBrigham and Women's Hospital, Division of Sleep Medicine, Sleep Disorders Program and Harvard Medical School, Boston, MA ; Neuroscience Research Australia (NeuRA), and the School of Medical Sciences, University of New South Wales, Sydney, New South Wales, Australia.
Atul MalhotraBrigham and Women's Hospital, Division of Sleep Medicine, Sleep Disorders Program and Harvard Medical School, Boston, MA ; Pulmonary and Critical Care Division, University of California San Diego, La Jolla, CA.
Andrew WellmanBrigham and Women's Hospital, Division of Sleep Medicine, Sleep Disorders Program and Harvard Medical School, Boston, MA.
David P WhiteBrigham and Women's Hospital, Division of Sleep Medicine, Sleep Disorders Program and Harvard Medical School, Boston, MA.
Brigham and Women's Hospital · USNeuroscience Research Australia · AU

Funding

HARVARD CLINICAL AND TRANSLATIONAL SCIENCE CENTER (UL1)UL1RR025758 · NCRR · HARVARD MEDICAL SCHOOL · PI NADLER, LEE MARSHALL · 2008 to 2011
$91.4M
Wakefulness and Forebrain Activation by Orexin NeuronsP01HL095491 · NHLBI · BETH ISRAEL DEACONESS MEDICAL CENTER · PI MOCHIZUKI, TAKATOSHI · 2010 to 2019
$25.1M
Obstructive Sleep Apnea Increases Cardiovascular Risk in Type 2 DiabetesR01HL110350 · NHLBI · BETH ISRAEL DEACONESS MEDICAL CENTER · PI PATEL, SANJAY R, VEVES, ARISTIDIS · 2012 to 2016
$4.0M
SLEEP, AIRWAY PATENCY, AND THE PHARYNGEAL MUSCULATURER01HL048531 · NHLBI · UNIVERSITY OF COLORADO DENVER · PI WHITE, DAVID P. · 1992 to 2009
$3.8M
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
Assessment of Upper Airway Mechanics Using Newer EMG TechniquesK24HL093218 · NHLBI · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI MALHOTRA, ATUL · 2009 to 2013
$857k
NCRR NIH HHS RR 025758-01NCRR NIH HHS UL1 RR025758NHLBI NIH HHS 5R01HL048531NHLBI NIH HHS K24 HL 093218NHLBI NIH HHS P01 HL 095491NHLBI NIH HHS R01 HL085188NHLBI NIH HHS R01 HL090897NHLBI NIH HHS R01HL110350PHS HHS R01 102231
6 · The paper itself

Abstract

STUDY

objectivesThe 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.

designPatients were studied on 4 separate nights according to a within-subjects cross-over design.

settingSleep physiology laboratory. PATIENTS: Seven patients with OSA and a low respiratory arousal threshold.

interventionsIn-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

resultsTrazodone increased the respiratory arousal threshold by 32 ± 6% (-11.5 ± 1.4 versus -15.3 ± 2.2 cmH2O, 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.

conclusionsTrazodone 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.

Indexed as

Continuous Positive Airway PressureAdultArousalCross-Over StudiesFemaleHumansHypnotics and SedativesMaleMiddle AgedPolysomnographyRespirationRespiratory SystemSleepSleep Apnea, ObstructiveTrazodoneWakefulnessHypnotics and SedativesTrazodoneArousallungmusclesrespiratory physiologysedativesleep-disordered breathingupper airway

Identifiers

PMID24899767
PMCPMC4044741
OpenAlexW2064414960

What OpenQuestion holds

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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.