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Effects of Naltrexone on Sleep Quality and Periodic Breathing at High Altitude.
Foster, Katharine; Anholm, James D; Foster, Gary; Thapamagar, Suman; Subedi, Prajan.
Afiliación
  • Foster K; Department of Emergency Medicine, Loma Linda University School of Medicine, Loma Linda, California, USA.
  • Anholm JD; Pulmonary & Critical Care, VA Loma Linda Healthcare System, Loma Linda, California, USA.
  • Foster G; Department of Medicine, Loma Linda University School of Medicine, Loma Linda, California, USA.
  • Thapamagar S; Cardiology, St. Charles Health System, Bend, Oregon, USA.
  • Subedi P; Department of Medicine, Loma Linda University School of Medicine, Loma Linda, California, USA.
High Alt Med Biol ; 2024 Jul 05.
Article en En | MEDLINE | ID: mdl-38966963
ABSTRACT
Foster, Katharine, James D. Anholm, Gary Foster, Suman Thapamagar, and Prajan Subedi. Effects of naltrexone on sleep quality and periodic breathing at high altitude. High Alt Med Biol. 00000-000, 2024.

Objective:

This study examined the effects of naltrexone on breathing and sleep at high altitude. Mu-opioid receptor (MOR) agonists have a depressive effect on respiration. Naltrexone is known to block the MOR. We hypothesized that MOR blockade with naltrexone would result in higher nocturnal oxygen saturations, fewer apneas, and improved sleep at high altitude.

Methods:

This double-blind, placebo-controlled, crossover study included nine healthy volunteers (four females, five males) aged 27.9 (4.6) (mean [standard deviation]) years. Two overnight trips spaced at least 2 weeks apart took participants from Loma Linda, CA (355 m) to the Barcroft Laboratory, CA (3,810 m) for each arm. Participants ingested either 50 mg naltrexone or matching placebo at bedtime. Sleep metrics were recorded using an ambulatory physiological sleep monitor (APSM). Subjective data were measured with the Groningen Sleep Quality Scale, Stanford Sleepiness Scale, and the 2018 Lake Louise Score (LLS) for acute mountain sickness (AMS).

Results:

Mean overnight SpO2 was lower after taking naltrexone, 81% (6) versus 83% (4) (mean difference 1.9% [2.1, 95% confidence interval or CI = 0.1-3.6, p = 0.040]). The lowest overnight SpO2 (nadir) was lower on naltrexone 70% (6) versus 74% (4) (dif. 4.6% [4.3], CI = 1.0-8.2, p = 0.020). Total sleep time and total apnea-hypopnea index were unchanged. Subjective sleep quality was significantly worse on naltrexone measured via the Groningen Sleep Quality Scale (p = 0.033) and Stanford Sleepiness Scale (p = 0.038). AMS measured via LLS was significantly worse while taking naltrexone (p = 0.025).

Conclusion:

Contrary to our hypothesis, this study demonstrated a significant decrease in nocturnal oxygen saturation, worse sleep quality, and AMS scores. Further characterization of the MOR's effects on sleep and AMS is needed to evaluate potential exacerbating mechanisms for AMS and poor sleep quality at altitude.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: High Alt Med Biol Asunto de la revista: BIOLOGIA / MEDICINA Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: High Alt Med Biol Asunto de la revista: BIOLOGIA / MEDICINA Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos