Effects of suvorexant on sleep apnea in patients with heart failure: A protocol of crossover pilot trial.


Journal

Journal of cardiology
ISSN: 1876-4738
Titre abrégé: J Cardiol
Pays: Netherlands
ID NLM: 8804703

Informations de publication

Date de publication:
Jul 2019
Historique:
received: 23 11 2018
revised: 23 12 2018
accepted: 30 12 2018
pubmed: 10 2 2019
medline: 24 6 2020
entrez: 10 2 2019
Statut: ppublish

Résumé

Suvorexant, an orexin receptor antagonist, is known as a safe and effective sleep medication. Many patients with heart failure (HF) have sleep-disordered breathing (SDB) and are short sleepers, and it is unknown whether suvorexant is effective in HF patients and can improve insomnia safely. The aim of this study is to examine the effect of suvorexant on SDB in patients with HF. The Heart Failure with Insomnia and Suvorexant trial of Juntendo University Hospital and Juntendo Shizuoka Hospital (J-FLAVOR trial) is a multicenter trial with a randomized double crossover design. We will enroll a total of 30 HF patients treated in the Juntendo University Hospital and Juntendo Shizuoka Hospital. Eligible patients will undergo portable sleep monitoring twice with or without oral administration of suvorexant in a randomly assigned order. Before the study night, patients in the suvorexant first group will receive suvorexant for 4 consecutive days. There are at least 3 wash-out days between the study nights with and without suvorexant. Primary outcome measures of the non-inferiority trial of suvorexant include the apnea-hypopnea index and the severity of SDB, and the results will be compared between the study nights with and without suvorexant. The present study can determine whether suvorexant can be used in HF patients without affecting their SDB. This is a pilot study to primarily assess whether suvorexant affects the severity of SDB in patients with HF. Therefore, further study is warranted to investigate whether suvorexant alters short- and long-term clinical outcomes by providing longer and better sleep in patients with HF.

Sections du résumé

BACKGROUND BACKGROUND
Suvorexant, an orexin receptor antagonist, is known as a safe and effective sleep medication. Many patients with heart failure (HF) have sleep-disordered breathing (SDB) and are short sleepers, and it is unknown whether suvorexant is effective in HF patients and can improve insomnia safely. The aim of this study is to examine the effect of suvorexant on SDB in patients with HF.
METHODS METHODS
The Heart Failure with Insomnia and Suvorexant trial of Juntendo University Hospital and Juntendo Shizuoka Hospital (J-FLAVOR trial) is a multicenter trial with a randomized double crossover design. We will enroll a total of 30 HF patients treated in the Juntendo University Hospital and Juntendo Shizuoka Hospital. Eligible patients will undergo portable sleep monitoring twice with or without oral administration of suvorexant in a randomly assigned order. Before the study night, patients in the suvorexant first group will receive suvorexant for 4 consecutive days. There are at least 3 wash-out days between the study nights with and without suvorexant. Primary outcome measures of the non-inferiority trial of suvorexant include the apnea-hypopnea index and the severity of SDB, and the results will be compared between the study nights with and without suvorexant.
CONCLUSION CONCLUSIONS
The present study can determine whether suvorexant can be used in HF patients without affecting their SDB. This is a pilot study to primarily assess whether suvorexant affects the severity of SDB in patients with HF. Therefore, further study is warranted to investigate whether suvorexant alters short- and long-term clinical outcomes by providing longer and better sleep in patients with HF.

Identifiants

pubmed: 30737183
pii: S0914-5087(19)30008-5
doi: 10.1016/j.jjcc.2018.12.021
pii:
doi:

Substances chimiques

Azepines 0
Sleep Aids, Pharmaceutical 0
Triazoles 0
suvorexant 081L192FO9

Types de publication

Clinical Trial Protocol Journal Article Multicenter Study

Langues

eng

Sous-ensembles de citation

IM

Pagination

90-94

Informations de copyright

Copyright © 2019 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.

Auteurs

Jun Shitara (J)

Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan.

Takatoshi Kasai (T)

Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan; Cardiovascular Respiratory Sleep Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan; Sleep and Sleep Disordered Breathing Center, Juntendo University Hospital, Tokyo, Japan. Electronic address: kasai-t@mx6.nisiq.net.

Sato Akihiro (S)

Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan; Cardiovascular Respiratory Sleep Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan.

Shoichiro Yatsu (S)

Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan.

Hiroki Matsumoto (H)

Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan; Cardiovascular Respiratory Sleep Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan.

Shoko Suda (S)

Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan.

Manabu Ogita (M)

Department of Cardiology, Juntendo University Shizuoka Hospital, Shizuoka, Japan.

Naotake Yanagisawa (N)

Medical Technology Innovation Center, Juntendo University, Tokyo, Japan; Clinical Research and Trial Center, Juntendo University Hospital, Tokyo, Japan.

Kazutoshi Fujibayashi (K)

Medical Technology Innovation Center, Juntendo University, Tokyo, Japan; Clinical Research and Trial Center, Juntendo University Hospital, Tokyo, Japan.

Shuko Nojiri (S)

Medical Technology Innovation Center, Juntendo University, Tokyo, Japan; Clinical Research and Trial Center, Juntendo University Hospital, Tokyo, Japan.

Yuji Nishizaki (Y)

Medical Technology Innovation Center, Juntendo University, Tokyo, Japan; Clinical Research and Trial Center, Juntendo University Hospital, Tokyo, Japan.

Naoko Ono (N)

Faculty of International Liberal Arts, Juntendo University, Tokyo, Japan.

Satoru Suwa (S)

Department of Cardiology, Juntendo University Shizuoka Hospital, Shizuoka, Japan.

Hiroyuki Daida (H)

Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan.

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