Trial reportJournal of applied physiology (Bethesda, Md. : 1985)2021
Different antimuscarinics when combined with atomoxetine have differential effects on obstructive sleep apnea severity.
Trial report in Journal of applied physiology (Bethesda, Md. : 1985), 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 24 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
24 citing papers in PubMed, 1 synthesis or guideline pooled it, 39 citations in OpenAlex.
- Are noradrenergics combined with antimuscarinics the future pharmacologic treatment for obstructive sleep apnea? A systematic review and meta-analysis of randomized controlled trials.Sleep & breathing = Schlaf & Atmung · 2024Pooled it
- The norepinephrine reuptake inhibitor reboxetine alone reduces obstructive sleep apnea severity: a double-blind, placebo-controlled, randomized crossover trial.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2023Trial
- Combination of atomoxetine with the novel antimuscarinic aroxybutynin improves mild to moderate OSA.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2022Trial
- Atomoxetine and fesoterodine combination improves obstructive sleep apnoea severity in patients with milder upper airway collapsibility.Respirology (Carlton, Vic.) · 2022Trial
- A single dose of noradrenergic/serotonergic reuptake inhibitors combined with an antimuscarinic does not improve obstructive sleep apnoea severity.Physiological reports · 2022Trial
- Precision Pharmacotherapy for Obstructive Sleep Apnea: Matching Targeted Drugs to Patient Endophenotypes.Pharmaceuticals (Basel, Switzerland) · 2026Review
- Pharmacotherapy in obstructive sleep apnoea: a clinical guide.Sleep & breathing = Schlaf & Atmung · 2026Review
- Targeting Hypoglossal Neurobiology in the Treatment of Obstructive Sleep Apnea: The Emergence of Aroxybutynin-Atomoxetine (AD109).Brain sciences · 2026Article
- Mechanisms of upper airway muscle control in sleep reveal therapeutic targets for obstructive sleep apnea.American journal of respiratory cell and molecular biology · 2026Review
- Noradrenergic input to hypoglossal motoneurons is mediated by interneurons located in prehypoglossal region.Journal of applied physiology (Bethesda, Md. : 1985) · 2026Article
- Review
- Review
- Cholinergic modulation of upper airway control: maturational changes and mechanisms at cellular and synaptic levels.Journal of neurophysiology · 2025Review
- Efficacy of atomoxetine and oxybutynin in the treatment of pediatric obstructive sleep apnea, a three case report.Frontiers in sleep · 2025Article
- The Emerging Role of Pharmacotherapy in Obstructive Sleep Apnea.Journal of otorhinolaryngology, hearing and balance medicine · 2024Article
- Pharmacological interventions for the treatment of obstructive sleep apnea syndrome.Frontiers in medicine · 2024Article
- A muscarinic, GIRK channel-mediated inhibition of inspiratory-related XII nerve motor output emerges in early postnatal development in mice.Journal of applied physiology (Bethesda, Md. : 1985) · 2023Article
- Optical and pharmacological manipulation of hypoglossal motor nucleus identifies differential effects of taltirelin on sleeping tonic motor activity and responsiveness.Scientific reports · 2023Article
- Development of a combination of noradrenergic and antimuscarinic drugs for the treatment of obstructive sleep apnea: Challenges and progress.Frontiers in sleep · 2023Review
- Thyrotropin-releasing hormone analog as a stable upper airway-preferring respiratory stimulant with arousal properties.Journal of applied physiology (Bethesda, Md. : 1985) · 2022Article
Corrections and comments
- Erratum issued
Authors and funding
7 authors at 3 institutions in 2 countries.
Funding
Abstract
The combination of the noradrenergic agent atomoxetine plus the antimuscarinic oxybutynin has recently been shown to improve upper airway physiology and reduce obstructive sleep apnea (OSA) severity. However, the effects of different antimuscarinics when combined with atomoxetine is limited. This study aimed to determine the effects of atomoxetine combined with two different antimuscarinics with varying M-subtype receptor selectivity on OSA severity and upper airway physiology. Ten people with predominantly severe OSA completed a double-blind, randomized, placebo-controlled, cross-over trial. Participants completed three overnight in-laboratory sleep studies after either 80 mg atomoxetine + 5 mg solifenacin succinate (ato-sol) or 80 mg atomoxetine + 2 mg biperiden hydrochloride (ato-bip) or placebo. OSA severity, ventilatory stability (loop gain), respiratory-arousal threshold (via epiglottic manometry), next-day subjective sleepiness [Karolinska Sleepiness Scale (KSS)], and alertness were compared between conditions. Neither drug combination altered the apnea/hypopnea index versus placebo (
Indexed as
Identifiers
What Socratic holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.