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Ludovico Messineo


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 www.clinicaltrials.gov, 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

Retropalatal and retroglossal airway compliance in patients with obstructive sleep apnea.

Marques M, Genta PR, Azarbarzin A, Sands SA, Taranto-Montemurro L, Messineo L, White DP, Wellman A

We hypothesized that preferential retropalatal as compared to retroglossal collapse in patients with obstructive sleep apnea was due to a narrower retropalatal area and a higher retropalatal compliance. Patients with a greater retropalatal compliance would exhibit a recognizable increase in negative effort dependence (NED). Retropalatal airway is narrower and more collapsible than retroglossal airway. Retropalatal compliance is reflected in the clinically-available NED value.

Breath-holding as a means to estimate the loop gain contribution to obstructive sleep apnoea.

Messineo L, Taranto-Montemurro L, Azarbarzin A, Oliveira Marques MD, Calianese N, White DP, Wellman A, Sands SA

Palatal prolapse as a signature of expiratory flow limitation and inspiratory palatal collapse in patients with obstructive sleep apnoea.

Azarbarzin A, Sands SA, Marques M, Genta PR, Taranto-Montemurro L, Messineo L, White DP, Wellman A

Broadband Sound Administration Improves Sleep Onset Latency in Healthy Subjects in a Model of Transient Insomnia.

Messineo L, Taranto-Montemurro L, Sands SA, Oliveira Marques MD, Azabarzin A, Wellman DA

In an experimental model of transient insomnia in young healthy individuals, broadband sound administration significantly reduced sleep onset latency by 38% compared to normal environmental noise. These findings suggest that broadband sound administration might be helpful to minimize insomnia symptoms in selected individuals.

Predicting epiglottic collapse in patients with obstructive sleep apnoea.

Azarbarzin A, Marques M, Sands SA, Op de Beeck S, Genta PR, Taranto-Montemurro L, de Melo CM, Messineo L, Vanderveken OM, White DP, Wellman A

Effect of 4-Aminopyridine on Genioglossus Muscle Activity during Sleep in Healthy Adults.

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

We tested the hypothesis that administration of a single dose of 4-AP 10 mg extended release would increase genioglossus activity (electromyography of the genioglossus muscle [EMG]) during wakefulness and sleep, and thereby decrease pharyngeal collapsibility. A single dose of 4-AP 10 mg extended release showed only a small increase in tonic EMG during REM sleep in this group of healthy subjects. We speculate that a higher dose of 4-AP may further increase EMG. However, given the potentially severe, dose-related adverse effects of this drug, including seizures, the administration of 4-AP does not appear to be an effective strategy to increase genioglossus activity during sleep in humans. Clinical Trial registered with clinicaltrials.gov (NCT02656160).

Phenotyping-based treatment improves obstructive sleep apnea symptoms and severity: a pilot study.

Messineo L, Magri R, Corda L, Pini L, Taranto-Montemurro L, Tantucci C

Treating OSA patients with a personalized combination of pharmacological and behavioral therapies according to phenotypic traits leads to a significant improvement in AHI, ODI, and subjective sleepiness.

Cardiac Sympathetic Hyperactivity in Patients with Chronic Obstructive Pulmonary Disease and Obstructive Sleep Apnea.

Taranto-Montemurro L, Messineo L, Perger E, Salameh M, Pini L, Corda L, Ferliga M, Tantucci C

Oronasal masks require higher levels of positive airway pressure than nasal masks to treat obstructive sleep apnea.

Bettinzoli M, Taranto-Montemurro L, Messineo L, Corda L, Redolfi S, Ferliga M, Tantucci C

Therapeutic CPAP level for OSAH is higher when administered via oronasal mask, leaving more residual events. These findings suggest that nasal mask should be the first choice for OSAH treatment.