Why does my family doctor not want to prescibe sleep medications to me to help me sleep, when I use the sleep breathing machine? She told me that was dangerous? I don’t understand why? I wake up often because of the apperatus, as it is uncomfortable and noisy. I have tried different masks, but still have the same problems with them.
If I take a sleeping pill I sleep well…or so it seems to me. Is it dangerous? I take antihistimies to sleep instead, but a sleeping prescription works best for me. I don’t take it every night, but when needed. Thank you for time and reply.
Dr. Joshua’s Answer:
Your doctor is correct in that hypnotics (tranquilizers, sleeping pills) are generally not recommended for persons with sleep apnea, as they may worsen the condition. However, nothing in medicine is categorical, and treatment should always be tailored to the individual, resources permitting.
Ideally, you should have a polysomnography with and without hypnotics in order to acquire objective evidence of the effects of tranquilizers in your case. However, this is an expensive approach.
If you are bothered by the CPAP equipment and sleep better and feel better the following day after having taken a hypnotic, it is conceivable that you may benefit from a hypnotic.
There is some (although quite limited) evidence that non-benzodiazepine hypnotics such as zolpidem do not have negative effects on the sleep of persons with sleep apnea on CPAP treatment. They may be of benefit to certain individuals.
Discuss the possibility of zolpidem treatment with your doctor. As always, it is not recommended to take zolpidem or any other sleeping pills on a regular basis - they all have detrimental effects on memory and other cognitive function, as well as the possibility of dependency. It is advisable to resort to hypnotics only when needed.
Literature references:
Advances in Obstructive Sleep Apnea
EFFECT OF ZOLPIDEM ON THE EFFICACY OF NASAL CONTINUOUS POSITIVE AIRWAY PRESSURE AS TREATMENT OF OBSTRUCTIVE SLEEP APNEA
Prakash B. Patel, MD* and Richard B. Berry, MD
Journal of Clinical Sleep Medicine, Vol. 1, No. 2, 2005 129
Does Zolpidem Enhance the Yield of Polysomnography?
Christopher J. Lettieri, M.D.; Arn H. Eliasson, M.D.; Teotimo Andrada, M.S.; Andrei Khramtsov, M.D.; David A. Kristo, M.D.
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