Intervention | Diagnostic | Dead space | Zolpidem | Lorazepam | Washout | Duloxetine | Duloxetine and CPAP | ||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Timeline (day within intervention) | 1 | 2 | 1 | 2 | 22 | 32 | 2 | 12 | 30 | 14 | 22 | 35 | 2 | 40 | 150 |
Sleep characteristics | |||||||||||||||
AHI (h) | 30.4 | 11.1 | 14.3 | 8.0 | 22.2 | 9.5 | 10.8 | 7.5 | 9.4 | 14.0 | 17.7 | 31.5 | 4.8 | 3.0 | 2.2 |
CA (n) | 23 | 18 | 22 | 3 | 15 | 11 | 8 | 6 | 7 | 17 | 7 | 15 | 13 | 8 | 3 |
Longest CA (s) | 171.0 | 184.0 | 111.0 | 71.5 | 68.0 | 168.0 | 82.0 | 72.0 | 72.0 | 120.5 | 56.0 | 40.0 | 98.5 | 49.0 | 23.0 |
OA (n) | 85 | 20 | 24 | 19 | 18 | 19 | 20 | 15 | 19 | 45 | 51 | 88 | 1 | 5 | 3 |
Hypopnoea (n) | 29 | 28 | 27 | 37 | 115 | 47 | 46 | 25 | 41 | 36 | 86 | 131 | 12 | 3 | 4 |
AI (s) | 39.3 | 45.5 | 38.3 | 31.6 | 30.9 | 51.6 | 35.0 | 31.3 | 33.6 | 39.2 | 25.0 | 24.7 | 29.4 | 17.1 | 18.2 |
CL (s) | 49.3 | 54.4 | 42.2 | 40.1 | 44.6 | 64.0 | 48.4 | 39.0 | 41.5 | 48.7 | 33.1 | 35.2 | 38.9 | 24.4 | 25.4 |
Min SaO2 (%) | 32 | 62 | 69 | 81 | 71 | 43 | 67 | 61 | 61 | 58 | 71 | 80 | 79 | 86 | 88 |
Snore (% of TST) | 30.6 | 5.0 | 47.0 | 18.0 | 28.2 | 30.0 | 33.2 | 27.3 | 13.8 | 21.2 | 40.0 | 39.0 | 0.4 | 0.1 | 2.6 |
TST (min) | 272 | 350 | 306 | 435 | 404 | 468 | 411 | 424 | 432 | 424 | 511 | 460 | 353 | 426 | 380 |
SOL (min) | 25.0 | 2.0 | 68.0 | 8.5 | 5.0 | 27.0 | 13.5 | 12.0 | 12.0 | 2.5 | 7.5 | 8.5 | 4.0 | 7.5 | 5.0 |
WASO (min) | 185.0 | 50.0 | 44.0 | 19.0 | 73.5 | 52.5 | 22.0 | 43.0 | 9.5 | 50.0 | 40.0 | 32.5 | 130.0 | 10.0 | 38.0 |
MSLT (min) | 16.6 | 15.0 | 13.6 | 15.5 | 11.6 | 18.6 | 6.3 | 7.6 | 6.8 | 16.6 | 15.8 | 11.4 | 15.5 | 15.6 | 15.3 |
Physiological indexes measured | |||||||||||||||
Respiratory rate (range, breaths/min) | |||||||||||||||
Daytime (wake) | 29–34 | 27–35 | 26–29 | 22–28 | 30–31 | 24–28 | 28–34 | 24–26 | 21–26 | 27–32 | 23–27 | 16–23 | 16–25 | 17–21 | 16–20 |
SOL | 27–35 | 27–35 | 22–26 | 20–25 | 23–29 | 22–25 | 26–28 | 25–27 | 22–25 | 27–31 | 24–29 | 21–25 | 15–25 | 15–21 | 15–23 |
NREM stage 2 | 15–17 | 14–17 | 14–16 | 14–16 | 14–15 | 14–15 | 14–15 | 15–16 | 15–16 | 14–15 | 13–15 | 12–15 | 15–16 | 14–15 | 15–16 |
TcpCO2 measured (range, mm Hg) | |||||||||||||||
Daytime (wake) | NA | 25–27 | 26–28 | 38–42 | 32–35 | 37–40 | 29–35 | 39–43 | 40–43 | 26–29 | 37–41 | 44–47 | 39–46 | 37–48 | 34–46 |
SOL | NA | 21–25 | 25–34 | 39–43 | 31–42 | 31–36 | 31–34 | 31–35 | 37–38 | 23–28 | 31–33 | 43–46 | 38–51 | 42–54 | 39–43 |
NREM stage 2 | NA | 41–43 | 39–43 | 46–49 | 43–45 | 47–49 | 39–42 | 41–45 | 44–46 | 41–43 | 47–51 | 45–49 | 43–44 | 40–44 | 43–44 |
Arterial blood gas assessment | |||||||||||||||
pH values | NA | 7.47 | 7.40 | 7.39 | 7.44 | NA | 7.41 | 7.39 | NA | 7.42 | 7.40 | NA | NA | 7.40 | NA |
pCO2 (mm Hg) | NA | 28.1 | 33.7 | 40.9 | 33.0 | NA | 37.2 | 39.2 | NA | 31.7 | 40.7 | NA | NA | 42.7 | NA |
pO2 (mm Hg) | NA | 93 | 94.1 | 90.0 | 94.2 | NA | 93.2 | 91.1 | NA | 92.8 | 90.0 | NA | NA | 88.7 | NA |
A–a O2 gradient (mm Hg) | NA | 22 | 15.3 | 10.9 | 16.1 | NA | 12.0 | 11.7 | NA | 19.0 | 11.0 | NA | NA | 9.9 | NA |
A–a O2 gradient, alveolar–arterial O2 gradient; AHI, apnoea/hypopnoea index; AI, apnoeic interval; CA, central sleep apnoea; CL, cycle length; MSLT, multiple sleep latency test; NA, not available; NREM, non-rapid eye movement sleep; OA, obstructive sleep apnoea; SOL, sleep onset latency; TcpCO2 transcutaneous pCO2; TST, total sleep time; WASO, wake after sleep onset.