This question was recently posted on Medscape's Physician connect:
I am treating a man who has sleep apnea and uses CPAP. He is on Trileptal and Lamictal. Recent problems with insomnia has made me suggest Sonata. Are there any concerns about this? Contraindications?
This is my answer (which also includes a response to a few of the comments posted on Physician Connect):
If a person is on an effective cpap pressure, the adverse effects of hypnotics should be no different than in someone without osa. I have treated thousands of patients with osa; some of them require ambien/lunesta/Sonata. I occasionally use benzodiazepines, especially restoril. There have been several studies showing that moderate doses of alcohol do not effect cpap requirements (not that I recommend alcohol). I do agree with having the patient check with the sleep clinic, however. What the patient is calling "insomnia" may be a sign of problems with cpap and should be addressed by his sleep physician.
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19 comments:
I thought sudden death wasn't an issue with sleep apnea?
Untreated sleep apnea prevents you from getting a good night’s sleep. When breathing is paused, you’re jolted out of your natural sleep rhythm. You should have it treated before it gets worst and make a living dead. Learn some
training courses about sleep apnea online and if you don't have time to go to a doctor.
Just take some sleeping pills.
Treatment for sleep apnea depends on the severity of the problem. Given the data on the long-term complications of sleep apnea, it is important for patients to treat the problem as they would any chronic disease.
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