Varenicline is used for smoking cessation as it inhibits the binding of nicotine to receptors in those experiencing nicotine dependence. Varenicline administration has recently been reported to affect sleep in a novel way.
A study by Pataka et. al (2021) evaluated changes in polysomnography (PSG) during Varenicline treatment in healthy smokers and smokers with obstructive sleep apnoea (OSA). Thirty smokers (21 men) with 15.3 ± 10.2 pack-year* habits, aged 32.8 ± 4.5 years, with BMI 28.6 ± 4 kg/m2; 14 with OSA (92% males) and 16 without were studied with PSG: before treatment with Varenicline (while smoking), 20–30 days during Varenicline administration, and following smoking cessation by at least 5 days.
No significant differences were observed in sleep macro architecture (N1, N2, N3, REM, Sleep Efficiency, Total Sleep Time) during Varenicline treatment apart from prolongation of sleep latency, and N2 and N3 latency in both smokers with and without OSA. The patients’ Apnoea Hypopnea Index (AHI) was reduced in OSA-smokers, especially during REM sleep, with a borderline increase of arousal index (AI) and reduction of sleep efficiency (SE).
The authors found that Varenicline treatment worsened sleep quality as a prolongation of sleep latency, N2, and N3 latency. A marginal reduction of AHI was found in OSA patients, though more significantly during REM where the airway would otherwise be at its most compromised. Due to the small sample size however, further studies are needed to distinguish between the adverse reactions of Varenicline treatment and smoking cessation effects, and to evaluate whether Varenicline may play a potential pharmacological role in the treatment of OSA, of which none currently exist.
*A pack-year is equivalent to smoking 20 cigarettes (1 pack) per day for 1 year.
Athanasia Pataka, Christos Frantzidis, George Kalamaras, Polyxeni Gkivogkli, Seraphim Kotoulas, Christiane Nday, Panteleimon Chriskos, Maria Karagianni, Charis Styliadis, Evangelos Paraskevopoulos, Chrysoula Kourtidou-Papadeli, Panagiotis Bamidis, Varenicline administration for smoking cessation may reduce apnea hypopnea index in sleep apnea patients, Journal of Sleep Medicine, Volume 88, 2021, Pages 87-89, ISSN 1389-9457.
https://doi.org/10.1016/j.sleep.2021.10.002.
https://www.sciencedirect.com/science/article/pii/S1389945721005037
