Varenicline administration for smoking cessation may reduce apnea hypopnea index in sleep apnea patients

Abstract

Objective/background: Varenicline (VAR) is used for smoking cessation as it inhibits nicotine for binding on its receptors reducing nicotine dependence. VAR administration has been reported to affect sleep. The aim of this study was to evaluate possible changes in polysomnography (PSG) during VAR treatment (SmokeFreeBrain) in healthy smokers and smokers with obstructive sleep apnea (OSA).

Patients/methods: Thirty smokers (21 men) with 15.3 ± 10.2 PY, aged 32.8 ± 4.5 years, with BMI 28.6 ± 4 kg/m², 16 without and 14 with OSA (92% males) were studied with PSG (Embletta MPR-Master) before treatment with VAR while smoking and 20-30 days during VAR administration and smoking cessation for at least 5 days.

Results: No significant differences were observed in sleep macro architecture (N1, N2, N3, REM, Sleep Efficiency, Total Sleep Time) during VAR treatment apart from prolongation of sleep latency, N2 and N3 latency in both smokers with and without OSA. Apnea hypopnea index (AHI) was reduced in OSA smokers and especially during REM with a borderline increase of arousal index (ArI) and reduction of sleep efficiency (SE).

Conclusion: VAR treatment worsened sleep quality as a prolongation of sleep latency, N2 and N3 latency was observed. A marginal reduction of AHI was found in OSA patients, more significantly during REM. Due to the small sample size, further studies are needed to distinguish between the adverse reactions of VAR treatment and smoking cessation effects and to evaluate whether VAR may play a role in OSA treatment.

Keywords: AHI; Obstructive sleep apnea; REM; Sleep; Smoking cessation; Varenicline.