Cold plus flu medications therapy does not improve OSA severity
26 Apr 2021
Combination treatment with pseudoephedrine and diphenhydramine has failed to improve obstructive sleep apnoea (OSA) severity or genioglossus responsiveness in a recent study, but it has led to a slight improvement in upper airway collapsibility, possibly due to the decongesting effect of the medications.
The investigators of the study determined the effects of the combination of an alpha-1 adrenergic agonist (pseudoephedrine) and an antihistaminic-antimuscarinic (diphenhydramine) on OSA severity (AHI), genioglossus responsiveness, and other endotypic traits (ie, ventilation at eupneic drive [Vpassive], muscle compensation, loop gain, and arousal threshold).
Ten OSA patients were included in this randomized, placebo-controlled, double-blind, crossover trial that compared one night of pseudoephedrine 120 mg plus diphenhydramine 50 mg (DAW1033D) to placebo administered before sleeping. The investigators measured the AHI, genioglossus muscle responsiveness to negative oesophageal pressure, and the endotypic traits via polysomnography.
The participants had a median age of 50 years (interquartile range [IQR], 46–53) and body mass index of 34.3 kg/m2 (IQR, 30.6–39.2).
The combination treatment showed no substantial effect on AHI (21.6 [IQR, 9.1–49.8] on placebo vs 37.9 [IQR, 5.1–55.4] events/h on DAW1033D; p>0.5) or genioglossus responsiveness (6.0 [IQR, 2.6–9.2] on placebo vs 4.0 [IQR, 3.5–7.3] %/cm H2O). Among the phenotypic traits, only Vpassive showed an improvement (mean % eupnoea, 29, 95 percent CI, 3–55; p=0.03).
“The results of this study do not support the use of these medications for OSA treatment,” the investigators said.