Effects of sildenafil on autonomic nervous function during sleep in obstructive sleep apnea

Neves, Christiane; Tufik, Sérgio; Chediek, Felipe; Poyares, Dalva; Cintra, Fátima Dumas; Roizenblatt, Marina; Abrantes, Fabiano Ferreira; Monteiro, Marina Ariza; Roizenblatt, Suely

doi:10.1590/s1807-59322010000400008

Cited by 23 publications

(21 citation statements)

References 46 publications

(48 reference statements)

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“…Neves et al . from the same group, evidenced not only a worsening in OSA respiratory data but also immediate cardiac effects due to autonomic system impairment in Sildenafil-treated patients with severe OSA 75. Since these two studies included only 13 severe untreated OSA patients, the external validation of the conclusions is compromised.…”

Section: Resultsmentioning

confidence: 98%

Effects of obstructive sleep apnea and its treatment over the erectile function: a systematic review

et al. 2017

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Erectile dysfunction (ED) is considered a condition with a broad range of etiologies. Obstructive sleep apnea (OSA) syndrome is one of the lesser studied risk factors for ED. We intend to summarize the current evidence on the relationship between OSA and sexual impairment, focusing on the results in terms of erectile function of the different therapies offered to OSA patients. A systematic review was conducted, selecting articles related to the physiology of OSA and ED, and to the treatments of OSA syndrome and their reported outcomes in erectile and sexual function. Higher prevalences of ED in the OSA groups have been published. However, whether this effect on the erectile function occurs in the entire range of OSA severities remains unclear. Several hypotheses were proposed to explain the physiology of this association. Continuous Positive Airway Pressure as a treatment for OSA patients with ED has achieved a significative improvement in the sexual parameters in most of the studies. Phosphodiesterase type 5 inhibitors (iPDE5) on demand are useful as a treatment for ED in this subgroup of patients, with high satisfaction rates. The surgical treatment for the OSA evidenced benefits over the erectile function, and the effect on the sexual satisfaction of the therapy using Mandibular Advancement Devices is still undefined.

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Section: Resultsmentioning

confidence: 98%

Effects of obstructive sleep apnea and its treatment over the erectile function: a systematic review

et al. 2017

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“…It is important to heighten public awareness regarding the potential hazards and health risks that surround untreated sleep apnea 1-7,28-34. In addition, certain groups of individuals, such as commercial drivers, need to realize that OSA is dangerous to them and to others.…”

Section: Discussionmentioning

confidence: 99%

A negative expiratory pressure test during wakefulness for evaluating the risk of obstructive sleep apnea in patients referred for sleep studies

Romano

Salvaggio

Bue

et al. 2011

Clinics

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OBJECTIVE: Obstructive sleep apnea is characterized by increased upper airway collapsibility during sleep. The present study investigated the use of the negative expiratory pressure test as a method to rule out obstructive sleep apnea.METHODS:Flow limitation was evaluated in 155 subjects. All subjects underwent a diurnal negative expiratory pressure test and a nocturnal sleep study. The severity of sleep apnea was determined based on the apnea-hypopnea index. Flow limitation was assessed by computing the exhaled volume at 0.2, 0.5, and 1.0 s (V0.2, V0.5, and V1.0, respectively) during the application of a negative expiratory pressure and expressed as a percentage of the previous exhaled volume. Receiver-operating characteristic curves were constructed to identify the optimal threshold volume at 0.2, 0.5, and 1.0 s for obstructive sleep apnea detection.RESULTS: Mean expiratory volumes at 0.2 and 0.5 s were statistically higher (p<0.01) in healthy subjects than in all obstructive sleep apneic groups. Increasing disease severity was associated with lower expiratory volumes. The V0.2 (%) predictive parameters for the detection of sleep apnea were sensitivity (81.1%), specificity (93.1%), PPV (98.1%), and NPV (52.9%). Sensitivity and NPV were 96.9% and 93.2%, respectively, for moderate-to-severe obstructive sleep apnea, and both were 100% for severe obstructive sleep apnea.CONCLUSION: Flow limitation measurement by V0.2 (%) during wakefulness may be a very reliable method to identify obstructive sleep apnea when the test is positive and could reliably exclude moderate and severe obstructive sleep apnea when the test is negative. The negative expiratory pressure test appears to be a useful screening test for suspected obstructive sleep apnea.

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“…Therefore, we believe that our investigation provides honest and useful information regarding the effects of the catalase inhibitor ATZ into the 4 th V on baroreflex components in conscious Wistar rats. These data present relevant information since currently, baroceptor reflex is largely studied in different models and strain of rats [14,15] aiming to prevent hypertension development in human [29,30], due to the fact that impaired autonomic regulation of cardiovascular system is indicative of cardiovascular disease [32][33][34][35].…”

Section: Discussionmentioning

confidence: 99%

Catalase Inhibition Into the Fourth Cerebral Ventricle Affects Bradycardic Parasympathetic Response to Increase in Arterial Pressure Without Changing the Baroreflex

Valenti

Abreu²,

Sato³

et al. 2011

J. Integr. Neurosci.

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Exogenous catalase influences neural control of cardiovascular system; however, we do not know yet if its inhibition into the fourth cerebral ventricle (4(th) V) influences baroreflex regulation. We evaluated the effects of central catalase inhibition on baroreflex in conscious Wistar rats. We used males Wistar rats (320-370 g), which were implanted with a stainless steel guide cannula into 4(th) V. The femoral artery and vein were cannulated for mean arterial pressure (MAP) and heart rate (HR) measurement and drug infusion, respectively. After basal MAP and HR recordings, the baroreflex was tested with a pressor dose of phenylephrine (PHE, 8 μg/kg, bolus) and a depressor dose of sodium nitroprusside (SNP, 50 μg/kg, bolus). Baroreflex was evaluated before 5, 15, 30 and 60 minutes after 3-amino-1, 2, 4-triazole (ATZ, 0.001 g/100 μL) injection into the 4(th) V. Vehicle treatment did not change baroreflex responses. ATZ attenuated bradycardic peak and reduced HR range at 30 minutes. ATZ into the 4(th) V reduced bradycardic and tachycardic reflex responses to increase and decrease MAP, respectively (p<0.05) 30 minutes after its microinjection without significantly changing the basal MAP and HR. In conclusion, central catalase inhibition influenced the highest parasympathetic response to MAP increase in conscious Wistar rats without change baroreflex gain.

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Effects of sildenafil on autonomic nervous function during sleep in obstructive sleep apnea

Cited by 23 publications

References 46 publications

Effects of obstructive sleep apnea and its treatment over the erectile function: a systematic review

Effects of obstructive sleep apnea and its treatment over the erectile function: a systematic review

A negative expiratory pressure test during wakefulness for evaluating the risk of obstructive sleep apnea in patients referred for sleep studies

Catalase Inhibition Into the Fourth Cerebral Ventricle Affects Bradycardic Parasympathetic Response to Increase in Arterial Pressure Without Changing the Baroreflex

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