EFFECTS OF PROTRIPTYLINE ON SNORING CHARACTERISTICS

We evaluated the effects of protriptyline on snoring characteristics i n 14 nonapneic snorers (age range, 23 to 54 years; body mass index, 27 .4+/-0.9 kg/m2, mean+/-SEM). The study design was a double-blind place bo-controlled crossover trial. Patients were evaluated during a polyso mnographic study after each 2 weeks of treatment. Breathing sounds wer e recorded with two microphones symmetrically placed on each side of t he bed, the signal being preamplified, equalized, and analyzed by usin g a real time analyzer. A snoring event was defined as a breathing sou nd with a sound pressure level (SPL) greater than 60 dB SPL. The snori ng index (number/sleep hour) and the sound intensity of each event wer e automatically determined. Mild side effects were observed in ten sub jects, but no subject interrupted the study because of them. The REM s leep time decreased with protriptyline with a parallel increase in sta ges 1 to 2. There was no difference in body position during sleep betw een the placebo and protriptyline trials. The snoring index decreased from 335+/-40 with placebo to 238+/-41 with protriptyline (p<0.05) wit h important individual differences. Among the different sleep stages, the highest values of the snoring index were observed in slow-wave sle ep with placebo. The snoring index decreased in each sleep stage with protriptyline, the highest decrease occurring in slow-wave sleep. The percentage of total sleep time (TST) spent above 60 dB SPL was signifi cantly lower with protriptyline (6.1+/-1.2 percent TST) than with plac ebo (8.6+/-1.2 percent TST). Changes in snoring characteristics were n ot correlated with snoring severity, the drug blood level, the body ma ss index, or the drug-induced modifications in sleep architecture. We conclude that protriptyline can improve both snoring frequency and lou dness in some nonapneic snorers, and that this improvement occurs most ly in the sleep stages where snoring is worst.