Temazepam 10mg does not affect breathing and gas exchange in patients with severe normocapnic COPD☆
Received 22 December 2008; accepted 27 October 2009. published online 13 November 2009.
Summary
Background
Benzodiazepines can improve sleep quality, but are also thought to cause respiratory depression in patients with chronic obstructive pulmonary disease (COPD). The aims of this study were to assess the effects of temazepam on indices of circadian respiratory function, dyspnea, sleep quality, and sleepiness in patients with severe COPD and insomnia.
Methods
In a double-blind, randomized, placebo-controlled, cross-over study in 14 stable patients with COPD (mean FEV1 0.99±0.3L) with insomnia, polysomnography with continuous transcutaneous capnography and oximetry, arterial gas sampling, hypercapnic ventilatory response, multiple sleep latency test, Epworth Sleepiness Scale, dyspnea and sleep visual analogue scales (VAS) were performed at baseline, after one week of temazepam 10mg at bedtime and after one week of placebo.
Results
Temazepam did not cause statistically significant changes in mean transcutaneous carbon dioxide tension during sleep compared to placebo (5.9±1.0kPa vs. 6.3±1.4kPa, p-value 0.27), nor in mean oxygen saturation (92±3% vs. 92±2%, p-value 0.31), nor in any of the other investigated variables, except for the total sleep time and sleep latency VAS, which improved with temazepam.
Conclusions
One week usage of temazepam 10mg does not influence circadian respiratory function, dyspnea, and sleepiness in patients with stable, severe, normocapnic COPD and insomnia and it improves total sleep time and subjective sleep latency. However, this is a preliminary explorative study for assessing the feasibility to perform a larger study on this topic. The clinical implications of this study are very limited.
aDepartment of Pulmonology, Rijnstate Hospital, Arnhem, The Netherlands
bDepartment of Pulmonology, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands
cDepartment of Clinical Pharmacy & Pharmacology, Rijnstate Hospital, Arnhem, the Netherlands
Corresponding author. Department of Pulmonology, Rijnstate Hospital, P.O. Box 9555, 6800 TA, Arnhem, The Netherlands. Tel.: +31 (0) 26 3786226; fax: +31 (0) 26 3786124.
☆ This study was registered at www.ClinicalTrials.gov as ‘Effects of temazepam in patients with chronic pulmonary obstructive disease’ (ID number NCT00245661).
ABSTRACT