Agomelatine for Sleep Measures in Obstructive Sleep Apnea

By Patrick Daly - Last Updated: January 13, 2023

Obstructive sleep apnea (OSA) is a common sleep disorder in which comorbid insomnia is a frequent complication. While benzodiazepines effectively improve sleep parameters, they may be a poor option for patients with OSA due to their disruption of the respiratory system and sleep rhythm.

Previously, research showed that melatonin improved duration and quality of sleep in patients with chronic obstructive pulmonary disease.

As such, Behnaz Niara and colleagues evaluated the impact of agomelatine, a melatonin receptor agonist, on polysomnography parameters in patients with OSA and sleep problems. In the study, published in the Journal of Pharmacy & Pharmaceutical Sciences, the team found short-term agomelatine could increase total sleep time (TST) and sleep efficiency.

Agomelatine in Obstructive Sleep Apnea Improves Sleep Quality

Agomelatine also reduced awakenings during sleep and, “contrary to other frequently used insomnia medications, agomelatine did not disturb sleep patterns and did not increase apnea attacks, leg movements, and arousal index,” the authors suggested.

The randomized trial enrolled 70 patients aged 18 years or older with OSA who were referred to the authors’ sleep clinic. Participants were randomized to a control group and an agomelatine group, which received 50 mg of agomelatine 1 hour before sleep for the 3 nights prior to polysomnography assessment.

Researchers determined the following 3 polysomnography parameters were significantly different between the agomelatine and control group:

Median and interquartile range of TST: 397 (interquartile range [IQR], 326.5-437.4) versus 287.5 (IQR, 184-393.1; P=.004)
Sleep efficiency percentage: 75.6 (IQR, 71-87.4) versus 65.1 (IQR, 50.8-80.1; P=.005)
Wakening percentage: 7.5 (12.01-27.6) versus 8.8 (18.3-49; P=.004)

In addition, the researchers noted sleep onset was earlier in the agomelatine group compared with the control group; however, the difference was not statistically significant.

Given all of their findings, Niara and the team suggested that “using agomelatine may be superior to other hypnotics in patients with OSA and insomnia due to its favorable therapeutic effects,” although they did add that further research is needed given the limitations of their study.