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August 8, 2018

Could non-prescription sleeping pills be increasing the severity of your sleep apnea?

Insomnia is a common sleep disorder, with about 30 percent of adults reporting acute insomnia at some point in their lives. Pair that with the fact that 54 million people in the United States also suffer from sleep apnea, and it’s no wonder that some have both insomnia and sleep apnea, though they may not know it.

Treatments of insomnia can vary, and it is important for those who use over-the-counter medicine for their insomnia to be aware of how these medicines can increase or worsen sleep apnea.

Insomnia is characterized by having trouble falling asleep, staying asleep, or a combination of both. Acute insomnia lasts for a few days or 3 months at most, and can be brought on by stressful situations that eventually pass with time, like stress in the workplace, a traumatic incident, or temporary stressors like job loss, illness, and divorce.

Sleep apnea occurs when there are pauses in breathing during sleep, often associated with a partial or complete blockage within the throat. This happens when you lie down to sleep and the muscles in your throat relax. This may lead to a shift in the tongue or soft palate, causing your airway to narrow so much that it briefly closes off completely. This disrupts breathing and may reduce the level of oxygen in the blood.

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There are many parallel symptoms that sleep apnea and insomnia share, like frequent awakenings, impaired cognitive functioning during the day, and feeling tired all the time. Some research points to strong links between sleep apnea and insomnia, and the two are sometimes treated concurrently.

Some people choose to treat their acute insomnia with over-the-counter sleeping pills that contain diphenhydramine, like Tylenol PM, Benadryl, Advil PM, ZzzQuil, or allergy treatments that contain sleep aids. However, the use of these medicines, which are marketed as helping people to fall asleep and stay asleep, can have adverse effects on those suffering from even mild sleep apnea. Why? It all comes down to relaxation.

Sleeping pills quiet the mind and relax the body to allow sleep to set in. It’s natural for the body and throat structures to relax to some degree during sleep. But when an already partially collapsed airway is aided even more by a muscle relaxant, sleep apnea has the potential to increase.

Sleep apnea impairs your attention span and short-term memory. It has also been linked to many health issues, including irregular heartbeat, high blood pressure, type 2 diabetes, depression, heart attack, and stroke, so it’s important that suspicions of sleep apnea be addressed by your doctor.

Additional care must be had if someone is taking over-the-counter sleeping pills (or using other sedatives like alcohol to help fall asleep) to manage their insomnia but not doing anything to treat their sleep apnea. If you believe you have sleep apnea, consult your doctor.

Brandon R. Peters, M.D., is board-certified in both neurology and sleep medicine and currently practices at Virginia Mason Medical Center in Seattle. He is also a Clinical Affiliate at Stanford University's School of Medicine in the Department of Psychiatry and Behavioral Sciences. His latest book, Insomnia Solved, is available on Amazon.