A major public health and safety concern is that current treatments for obstructive sleep apnoea (OSA) are intolerable or are inefficient at reducing the severity and symptoms of this common sleep and breathing disorder. This is because the causes of OSA vary substantially among patients and no single treatment works for all. This is a major problem for more than one million Australian adults who suffer from OSA, as many are without adequate treatment and at increased risk of cardiovascular disease, impaired brain function, sleepiness and its consequences including motor vehicle and work-related accidents.
More than 5% of adults report using sleeping pills within the previous month to promote sleep. Surprisingly, there is little evidence on the effects of sleeping pills in OSA. While some sleeping pills may make OSA worse, others may be beneficial for certain patients.
This study looked at the effects of three commonly used sleeping pills on major causes of OSA, during sleep in healthy individuals and people with OSA.
The findings show differential effects of the sleeping pills on the respiratory arousal threshold (how easily an individual wakes to airway narrowing). The upper airway was not more collapsible and the activity of the muscles in the upper airway was not impaired..
Paradoxically, the study showed that one sleeping pill (zolpidem) may be particularly beneficial for certain OSA patients by increasing the activity of the muscles around the throat area which are important for keeping the airway open and preventing OSA.
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Future research need to examine the mechanisms of these paradoxical findings.