Ludovico Messineo


PhD Student

Ludovico was awarded his MD in 2012 with a thesis on multi-pharmacological therapy in obstructive sleep apnea patients. In 2016, he became a postdoctoral fellow at Harvard Medical School (HMS) in Boston, where he conducted a project, which aimed to find an innovative technology to predict unstable respiratory control (high loop gain of the respiratory system) in OSA patients and healthy subjects in a clinical setting. Currently, he is working with the Eckert team to investigate the effects of pharmacological and combination sleep apnea treatments on specific phenotypic traits.

Projects Ludovico Messineo is currently involved with


The Effects of “Z Drugs” in People With Obstructive Sleep Apnoea

Obstructive sleep apnoea (OSA) is a common disorder characterised by repetitive narrowing and collapse of the upper airway during sleep. It is associated with daytime sleepiness, neurocognitive impairment, and a variety of adverse cardiovascular consequences. The first line treatment for OSA is continuous positive airway pressure (CPAP) therapy. If tolerated, CPAP is highly effective in reducing sleep disordered breathing events. However, up to 50% of OSA patients are unable to tolerate CPAP therapy leaving many OSA patients without treatment.

Previous studies indicate that in selected obstructive sleep apnea participants a standard dose of a z-drug can shift the threshold for awakening during sleep (arousal) whilst maintaining the upper airway muscle activity required to keep the airway open. This study aims to investigate the effects of different doses of sleeping pills (Z-drugs) on how easily people wake up when the airway narrows during sleep, the activity of a major muscle located under the tongue (genioglossus) and obstructive sleep apnoea (OSA) severity and symptoms.


The Effects of “Z Drugs” in People With Obstructive Sleep Apnoea



The Combination of Atomoxetine and Oxybutynin Greatly Reduces Obstructive Sleep Apnea Severity: A Randomized, Placebo-Controlled, Double-Blind Crossover Trial.

Taranto-Montemurro L, Messineo L, Sands SA, Azarbarzin A, Marques M, Edwards BA, Eckert DJ, White DP, Wellman A

We aimed to determine the effects of the combination of a norepinephrine reuptake inhibitor (atomoxetine) and an antimuscarinic (oxybutynin) on OSA severity (apnea-hypopnea index, AHI; primary outcome) and genioglossus responsiveness (secondary outcome) in people with OSA. A combination of noradrenergic and antimuscarinic agents administered orally before bedtime on one night greatly reduced OSA severity. These findings open new possibilities for the pharmacologic treatment of OSA. Clinical trial registration available at, ID NCT02908529.

The hypoxic burden of sleep apnoea predicts cardiovascular disease-related mortality: the Osteoporotic Fractures in Men Study and the Sleep Heart Health Study.

Azarbarzin A, Sands SA, Stone KL, Taranto-Montemurro L, Messineo L, Terrill PI, Ancoli-Israel S, Ensrud K, Purcell S, White DP, Redline S, Wellman A

The 'hypoxic burden', an easily derived signal from overnight sleep study, predicts CVD mortality across populations. The findings suggest that not only the frequency but the depth and duration of sleezp related upper airway obstructions, are important disease characterizing features.

Neural memory of the genioglossus muscle during sleep is stage-dependent in healthy subjects and obstructive sleep apnoea patients.

Taranto-Montemurro L, Sands SA, Grace KP, Azarbarzin A, Messineo L, Salant R, White DP, Wellman DA
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