Drug Induced Apnea

Obstructive sleep apnea occurs when the soft tissues of the upper airway collapse creating a blockage that impairs or completely stops a person’s ability to breathe. If air is not being forced out through the nose and throat, blood oxygen levels drop causing the person to be startled awake. Sleep apnea often develops naturally. However, some people unwittingly bring on the condition through their use of prescription medications. Medications classified as benzodiazepines, opiates, and barbiturates have a significant effect on muscle tone, breathing, and sleep architecture. As a result, they have the ability to create a drug-induced apnea.

Opiates

For pain relief, doctors usually write patients a prescription for a medication in the drug classification known as opiates. Sometimes referred to as opioids or narcotics, these medications affect the central nervous system by binding themselves to opioid receptors. Because opiates affect the central nervous system, infrequent, shallow or otherwise irregular breathing can occur. Opiates can also create a sedative effect, slowing reflexes and motor skills. Here are some commonly prescribed opiates: 

  • Hydrocodone
  • Oxycodone
  • Fentanyl
  • Methadone
  • Morphine
  • Codeine

Benzodiazepines

Medications belonging to the drug classification called benzodiazepines are usually prescribed to patients for anxiety relief. Some of them have the ability to act as anti-seizure treatments or temporary sleep aids. These medications can also have a muscle relaxant effect and cause drowsiness, the side effects that can create the drug-induced apnea. Medications in this drug class include:

  • Alprazolam (Xanax)
  • Clonazepam (Klonopin)
  • Diazepam (Valium)
  • Lorazepam (Ativan)
  • Quazepam
  • Midazolam
  • Flurazepam
  • Restoril

Barbiturates

This class of medications was once widely used for sleep aids, but now is generally reserved for sedation prior to medical procedures because of the potential for those medications to cause dependence and induce coma. These drugs have a significant effect on the reticular activating system, which is responsible for regulating sleep architecture. Barbiturates also have an adverse effect on breathing, creating an onset of drug-induced apnea. Some commonly used barbiturates are:

  • Amobarbital
  • Phenobarbital
  • Pentobarbital
  • Secobarbital
  • Thiopental

People who suffer from sleep apnea or other sleep breathing disorders should exercise extreme caution when taking a benzodiazepine, opiate or barbiturate. All of the drugs in each of these drug classifications have the ability to increase the collapsibility of the soft tissues in a person’s upper airway. All three medication classifications have drugs that hinder a person’s consciousness or their ability to rouse themselves from a state of unconsciousness. People can suffer from irregular breathing, asphyxiation or sometimes death if they are unable to move their bodies or awaken themselves. These medications also disturb people’s natural sleep architecture. Although a person may be able to fall asleep, his or her ability to transition into and from the various stages of sleep may be interrupted by medications, which contributes to drug-induced apnea.

Some medications can pose a serious threat to healthy sleep, especially to those who already suffer from sleep apnea. People should confer with their doctors to make sure that the benefits of taking a medication outweigh the risks of developing drug-induced apnea. 

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