Definition
Among sleep disorders, sleep apnea is a real torment: also known as obstructive sleep apnea syndrome, the problem consists essentially in the obstruction of the upper airway during inspiration, which results in a reduction or arrest (temporary) of air flow in the lungs.
Causes
Sleep apnea occurs when the muscles located behind the throat relax: in such circumstances, the airways narrow during inspiration, temporarily blocking breathing.
- Risk factors: mandibular anomalies, CNS relaxing drugs, tongue enlargement, tonsil and adenoid hypertrophy, thickening of soft tissue surrounding the airways, acute mononucleosis, obesity, weak muscle tone
Symptoms
↓ alveolar ventilation → ↑ arterial pressure and carbon dioxide → poor quality and not very restful sleep
The intensity and duration of sleep apnea are subjective; in general, the most common symptoms consist of: dry mouth (upon awakening), difficulty in maintaining sleep, excessive daytime sleepiness, hypersomnia, sore throat and headache (upon awakening), sudden awakenings during sleep with lack of breath, snoring.
Information on sleep apnea - Medications for the treatment of sleep apnea is not intended to replace the direct relationship between health professional and patient. Always consult your doctor and / or specialist before taking Sleep Apnea - Sleep Apnea Medications.
drugs
Sleep apnea is a mild disorder only in appearance: in fact, the risk of complications increases exaggeratedly when the episodes of sleep apnea become frequent and the interruption time of the breath is quite long. Among the most alarming complications, cardiovascular disorders such as hypertension, stroke, atrial fibrillation and congestive heart failure stand out. Not to mention the risks incurred by patients with sleep apnea following surgery, being more prone to respiratory problems; even the administration of some drugs can weigh on sleep apnea.
The main goal of therapy for sleep apnea is to improve the quality of sleep of the patient who is affected, thus avoiding all the consequences that could result. Once again, the specific treatment must be customized to the individual patient, depending on the severity of the symptoms and the cause; for example, hypertrophy of the tonsils and adenoids in children can cause sleep apnea; in general, their surgical excision results in complete recovery from the nocturnal disturbance. In some affected patients, an oxygen mask is recommended to create positive pressure in the airways: this is a mini respirator (or ventilator) useful for keeping airways open between muscles released. Others need specific dental prostheses to push the mandible forward, especially patients subjected to the relaxation of the neck muscles during night rest: the application of the prosthesis is indicated not only for the prevention of sleep apnea, but also to improve breathing nocturnal in some affected subjects or at risk.
Since sleep apnea is recurrent in obese people, it is recommended, in this case, to follow a low-calorie diet to reduce body weight (see: article on drugs for the treatment of obesity); among other general rules, it is also recommended not to drink alcohol for 4-6 hours before going to bed, not to take sedative drugs and stop smoking.
Now let's see what drugs are used in therapy to ease the symptoms of sleep apnea.
First line drugs for the treatment of sleep apnea
Most patients with sleep apnea experience an unpleasant sensation of having slept badly, with repercussions during the day: the subject, in fact, tends to suffer from drowsiness. When daytime lethargy becomes important, it is sometimes advisable to administer stimulant drugs, such as amphetamine or anti-narcotics.
- Theophylline (eg Aminomal Elisir, Diffumal, Respicur) just like caffeine, theophylline is a xanthine drug used in therapy also (and not only) for the treatment of sleep apnea, useful both to reduce the frequency of episodes and to lighten them satellite symptoms, such as insomnia. Theophylline is also indicated for the treatment of the newborn's sleep apnea. As an alternative to theophylline, the newborn can be treated with oral administration of cafeina citrate (nymusa) at a dose of 10-20 mg / kg (maintenance dose: 5 mg / kg). Stop treatment with theophylline or caffeine after 7 days from the disappearance of symptoms.
- Modafinil (eg Provigil): the drug is a stimulant, indicated for the treatment of sleep disorders such as hypersomnia and narcolepsy in the context of sleep apnea; the active principle acts by promoting the release of neurotransmitters (monoamines), and raising the levels of histamine in the hypothalamus. The drug should be taken at a dose ranging from 150 to 250 mg, once a day, preferably in the morning. The dose varies according to the severity of the disorder: it is minimal in cases of mild hypersomnia and is higher when the disorder degenerates into narcolepsy in all respects (if sleep apnea is a serious problem). However, the effective dose, even for mild forms of drowsiness, should not fall below 150 mg.
- Amphetamine and Destrohamphetamine (eg DextroStat, Adderall, Dexedrine): belong to the class of sympathomimetic amines, substances that stimulate the central nervous system. It is recommended to start therapy with an oral dose of 10 mg taken per morning in the morning. Possibly, it is possible to correct the dosage for the maintenance phase, increasing by 10 mg every 7 days (not to exceed 60 mg per day), in addition to always dividing the dosages. This dose is generally considered for the treatment of narcolepsy. Lower dosages are indicated for treating moderate to moderate hypersomnia in the context of sleep apnea. The drug is also available as slow release capsules and oral solution. Consult your doctor.
See also: drugs for the treatment of hypersomnia
Note: it should be emphasized again: sleep apnea is an important problem in the obese: therefore, weight reduction is indispensable to lighten the respiratory problem, until it is completely eliminated when the ideal body weight is reached.
It is also advisable to abandon the supine position to sleep, preferring the side position: the implementation of this strategy seems to bring positive results on the problem of sleep apnea.
