Abstract Seven morbidly obese patients with sleep-related upper airway obstruction (UAO) were studied before and during progesterone treatment. All subjects had severe daytime somnolence, and five of the seven had congestive heart failure. All subjects were studied for one or two consecutive baseline nights in the sleep laboratory. Six of the seven subjects showed a mean of greater than 100 UAOs. Patients were treated for two to four weeks with medroxyprogesterone acetate, 20 mg three times daily. At the end of the treatment period, the sleep studies were repeated. There was no significant difference in the incidence, mean duration, or rate per minute of apneic episodes occurring before and with progesterone treatment. Severe hypoxemia during sleep persisted with treatment, as did the occurrence of cardiac arrhythmias. There was a significant improvement in the waking Pao2 with progesterone treatment. (Arch Intern Med 139:109-111, 1979) References 1. Tilkian AG, Guilleminault C, Schroedar JS, et al: Sleep-induced apnea syndrome: Prevalence of cardiac arrhythmias and their reversal after tracheostomy . Am J Med 63:348-358, 1977.Crossref 2. Lugaresi E, Coccagna G, Mantovani M, et al: Effects of tracheostomy in two cases of hypersomnia with periodic breathing . J Neurol Neurosurg Psychiatry 36:15-26, 1973.Crossref 3. Lyons HA, Huang CT: Therapeutic use of progesterone in alveolar hypoventilation associated with obesity . Am J Med 44:881-888, 1968.Crossref 4. Sutton FD, Zwillich CW, Creagh CE, et al: Progesterone for outpatient treatment of Pickwickian syndrome . Ann Intern Med 83:476-479, 1975.Crossref 5. Guilleminault C, Tilkian A, Dement WC: The sleep apnea syndromes . Annu Rev Med 27:465-484, 1976.Crossref 6. Rechtschaffen A, Kales A: A Manual of Standardized Terminology, Techniques and Scoring System for Sleep Stages of Human Subjects , publication 204. Bethesda, Md, Dept of Health, Education, and Welfare, Neurological Information Network, 1968. 7. Orr WC, Martin RJ, Imes NK, et al: Hypersomnolent and nonsomnolent patients with upper airway obstruction during sleep . Chest , to be published. 8. Laudau RL, Lugibihl K: Inhibition of the sodium-retaining influence of aldosterone by progesterone . J Clin Endocrinol Metab 18:1237-1245, 1958.Crossref 9. Oparil S, Lindheimer MD, Ehrlich EN: Effects of progesterone on volume homeostasis in man: Alterations in intrarenal sodium reabsorption, aldosterone excretion, and renin activity , in Fregley MJ (ed): Oral Contraceptives and High Blood Pressure . Gainesville, Fla, Dolphin Press, 1974, pp 170-183. 10. Sackner MA, Landa J, Forrest T, et al: Periodic sleep apnea: Chronic sleep deprivation related to intermittent upper airway obstruction and central nervous system disturbance . Chest 67:164-171, 1975.Crossref 11. Williams RL, Karacan I, Hursch CJ: Electroencephalography (EEG) of Human Sleep: Clinical Applications . New York, John Wiley & Sons, 1974.
Archives of Internal Medicine – American Medical Association
Published: Jan 1, 1979