taking xanax with apnea:please answer

I am exhausted from not good sleep since getting my cpap machine a week ago.

I have taken xanax before at night to help me sleep, but is it safe to take with having osa?

Have you taken it?

Thanks for your help

If your xanax prescription was for a sleep aid or antianxiety, and you've taken it without problems before you started using CPAP, I would think you'd have no problem. I've been using CPAP for about six months with good results, but I do take an occasional xanax [previously prescribed] to help get a sound night when things get wound up a bit too tight. I find it only enhances the effect of CPAP. I'm licensed to prescribe these meds, so I emphasize using the drug as previously prescribed by your MD.

Happy Papping,
Gary

bump

Let us put it this way - Taking sedatives with OSA that is not being treated is not the best thing to do just as drinking is not because your throat is more prone to close due to muscle relaxation and you are less likely to wake up and breathe. But if you are on cpap than it would probably be less dangerous because your airway is being kept open but on the medication you may need a higher pressure to keep the airway open otherwise you may have more apneas. But it is still probably less likely you will die if you are on cpap and take a sleeping aid.

We aren't even talking about what other effect the sleep aid may have on your quality of sleep or sleep architecture. But I would rather have a little less quality of sleep and actually get some sleep than sit up all night. The anti-anxiety med or maybe a sleep aid will help a newbie keep from ripping off the mask in the middle of the night and also help you to relax and accept the treatment.

I would be more worried on the Xanax that I would turn into an AXE murderer - JK

This from a guy that takes or has taken .5mg to 1mg of clonazepam with and without cpap many times and I have very severe OSA. I would not suggest taking it when not being treated with cpap as you may not wake up to breathe or you may wet the bed or you may not remember a damn thing when you wake up like how you fell asleep and why your on your knees on the floor in your underwear sleeping with your face on the sofa. My wife has a few pictures ...

garymbsail wrote:If your xanax prescription was for a sleep aid or antianxiety, and you've taken it without problems before you started using CPAP, I would think you'd have no problem. I've been using CPAP for about six months with good results, but I do take an occasional xanax [previously prescribed] to help get a sound night when things get wound up a bit too tight. I find it only enhances the effect of CPAP. I'm licensed to prescribe these meds, so I emphasize using the drug as previously prescribed by your MD.

Happy Papping,
Gary

Selling Viagra on the internet doesn't count Kidding

I have a prescription for Xanax which I need occasionally (a 30 day supply lasts me 2 years!). It doesn't seem to interfere with my CPAP therapy.

Pah, no way, nawda!! If it's a relaxation issue, I would meditate before bed!!!

If you generate daily Encore Reports, look at 'Avg daily time in Apnea'. Is the Xanax inhibiting your ability to wake up during Apnea, i.e. over thirty seconds or so... And, is it worth the chance to take a highly addictive drug??

Your Sleep Doctor is your best friend, give he/she a call and ask...

Good luck,

SG

Jazzmann wrote:
I have not had a good night sleep since starting my cpap a week ago. I just got a full faced mask today because of problems. I have taken xanax in the past when I could not sleep. I'm also nauseated I think due to sinus drainage, and my doctor ordered 12.5 phenergan. I'm scared to take either of these now that I know I have apnea. Has anyone else taken these at bedtime with your apnea?

What are the main problems you have been experiencing that has kept you awake? Perhaps we should look at that first - we might have some tips for you with those issues. Many or most of us, like you, had initial adjustments to make that disrupted our sleep.

I agree with Gary re. taking Xanax. if you were taking Xanax previous to CPAP (even THEN you probably had SA), perhaps now you might break the tablet in half and see how you do. I'm not a physician, but I was with the pharmaceutical company manufacturing Xanax when it first came out and I talked with physicians and addressed their questions. IMHO, I don't believe that occasional use of a mild dose would hurt you.

HOWEVER, I'd encourage you to try other "natural" helps first such as using earplugs to help you sleep, exercising during the day so you are tired at night . . . and dealing with the annoying CPAP issues to solve them with the help of the veteran CPAPers on this forum.

Joy

As others have stated taking central nervous system depressants, which is how xanax and all the other benzodiazepines work should not be a concern as long as you are being treated for OSA.

Benzodiazepines affect a key neurotransmitter in the brain called gamma-amino butyric acid (GABA). This neurotransmitter has an inhibitory effect on motor neurons, thus the presence of GABA slows or stops neuronal activity. Benzodiazepines enhance the activity of GABA, effectively slowing nerve impulses throughout the body. The human nervous system has two different types of benzodiazepine receptors: one that causes the anti-anxiety effect, and one that elicits the sedative effect.

There are differences in their time of action and their duration. Xanax also known as alprazolam is a "fast" acting short duration drug while Klonopin also known as clonazepam is a "slow" acting longer duration drug. I have experience with both of these and I am using CPAP. I take 2mg of Klonopin at bedtime and then usually wake up 3-4 hours later and many times take 1-2mg of Xanax to fall back to sleep. I have discussed this extensively with my psychiatrist and we have talked about the "highly addictive nature" of these compounds.

They are no more addictive than any other drug if misused. If the patient has a history of past or current drug or alcohol abuse then the likelihood of them abusing benzodiazepines is quite high. Benzodiazepine misuse is predominately combined with the abuse of other substances. Rarely is it the only agent being misused.

I have a fairly high state of anxiety particularly at bedtime, don't know why but it literally happened overnite, anyway I have been taking the above described doses of benzodiazepines for over a year and a half and have never abused their intended use or had the desire to misuse them. They are safe and extremely efficacious in controlling anxiety. They have helped me tremendously get through some pretty rough times. Bottom line I would not be too concerned with taking Xanax while being treated for OSA.

Just like others have mentioned Xanax is a relaxent. When it is working to help you sleep it is also relaxing your airway, therefor it is important to know if you took Xanax during your titration study? If so great the additional relaxing effect was titrated/accounted for, if not you will want to pay special attention to your fatigue if any. If you begin suffering from EDS(Excessive Daytime Sleepiness) again or if it never stopped you should talk to your doc about increasing your PAP pressure to help open the airway more and account for the relaxed airway muscles and tissue which can be exhaserbated by medications which include Xanax..

Benzodiazepines are highly addictive - physiologically addicitive. They are meant for short term use.

Protracted withdarawal symptoms from Benzodiazepines http://www.benzo.org.uk/pws04.htm

The syndrome includes (1) pharmacological withdrawal symptoms involving the slow reversal of receptor changes directly induced in the brain by benzodiazepines(1,5-7), and (2) psychological symptoms resulting indirectly from long-term benzodiazepine use, including exposure of poor stress ­coping abilities and other personal difficulties. These symptoms merge into a complex clinical picture that may be further complicated by (3) the reappearance of underlying anxiety or depression and (4) possibly also by ill-understood long-term neurological effects of benzodiazepines(1).

http://www.benzo.org.uk/profash.htm

ozij wrote:Benzodiazepines are highly addictive - physiologically addicitive. They are meant for short term use.

Protracted withdarawal symptoms from Benzodiazepines http://www.benzo.org.uk/pws04.htm

The syndrome includes (1) pharmacological withdrawal symptoms involving the slow reversal of receptor changes directly induced in the brain by benzodiazepines(1,5-7), and (2) psychological symptoms resulting indirectly from long-term benzodiazepine use, including exposure of poor stress ­coping abilities and other personal difficulties. These symptoms merge into a complex clinical picture that may be further complicated by (3) the reappearance of underlying anxiety or depression and (4) possibly also by ill-understood long-term neurological effects of benzodiazepines(1).

http://www.benzo.org.uk/profash.htm

The article you are quoting describes withdrawal symptoms and is not evidence of their "highly addictive" nature. If your criteria for a highly addictive drug is unpleasent withdrawal symptoms, then you would have to agree that Selective Serotonin Reuptake Inhibitors; i.e Lexapro, Zoloft, Celexa are also highly addictive. Because the doseage of these drugs like the benzodiazepines has to be tapered to minimize the equally unpleasent withdrawal symptoms of the above mentioned anti-depressants.

Furthermore, from your article there seems to be no consensus on the long term affects of benzodiazepines on brain abnormalities as measured by CT Scan, suggesting no phsiological change to the brain:

IV. OTHER BRAIN CHANGES

Since tolerance to and recovery from the cognitive changes associated with long-term benzodiazepine use is incomplete and some neurological symptoms appear to persist indefinitely, it is difficult to explain these symptoms only in terms of slowly reversible receptor adaptations. Perhaps some receptor changes are incompletely reversible but the possibility remains that long-term benzodiazepine use can cause permanent neurological damage. Curran et al.(38) suggest that chronic benzodiazepine use may be implicated in age-related cognitive decline and dementia, conditions associated with neuronal cell loss and cortical shrinkage. There is equivocal evidence in the literature that long-term or high dose benzodiazepine use may cause structural brain damage. Two CT (computerized axial tomography) studies gave contradictory results(57,58). However, Schmauss and Krieg(59) found a significant dose-related cerebral ventricular enlargement in 17 long-term high dose benzodiazepine users who had never abused alcohol compared with control subjects. Another CT study(41) found that some (7 out of 29 females) high dose benzodiazepine abusers showed signs of cerebral atrophy, an incidence significantly greater than in a random sample of 200 women from the general population. Moodley et al.(60) found marginal abnormalities in CT scan appearances (reductions in density in frontal and other brain regions) in long-term lorazepam but not diazepam users. These findings are difficult to interpret but suggest that long-term lorazepam use may induce minor neuroanatomical changes. However, the authors state that at present no anatomical or physiological inferences are justifiable. The most recent CT study(6 1) of 20 long-term benzodiazepine users aged 23-59 years compared with 36 age and sex matched controls found no differences in brain atrophy between the groups and concluded that long-term benzodiazepine therapy does not result in brain abnormalities that can be demonstrated by CT scans. Thus, present evidence suggests that the risk of cortical atrophy, if it occurs, applies mainly to long-term high dose benzodiazepine users and may be compounded by alcohol abuse. Further research with up-to-date imaging techniques is urgently needed to show whether or not benzodiazepines can cause permanent neurological damage.


Finally, the Summary of the article you linked to gives a different picture than the selective quotes you have chosen to post:

SUMMARY AND CONCLUSIONS

In a minority of patients, benzodiazepine withdrawal is followed by a protracted post-withdrawal syndrome lasting many months. Both pharmacological and psychological factors may be involved and the symptoms include anxiety, insomnia, depression, cognitive impairment and a variety of perceptual, motor, and gastrointestinal disturbances. Treatment for benzodiazepine dependence should take into account prolonged symptoms, which may be minimised by gradual dosage reduction and long-term therapeutic contact with appropriate psychological support.

There are always risks to taking any drug that alters the suite of neurochemicals in your brain. However, I believe that you are overstating the dangers of benzodiazepine use and that a close, honest, and open relationship with a well qualified psychiatrist or psycopharmacologist is the best way to minimize the risk and to recognize when a patient may be tracking toward an abusive use of the drug and away from a therapeutic use.

I am glad you went to site and selected further quotes from one part of one paper that I quoted. There is vast information on that site; I

I suggest anyone who is taking Benzodiazepines take some time to study that site and make up their mind how they want to proceed.

O.

Most MD's will deny the highly addictive nature of benzo's and z-drugs (sleep meds - lunestra, ambien, sonata).

jazzmynn wrote:I am exhausted from not good sleep since getting my cpap machine a week ago.

I have taken xanax before at night to help me sleep, but is it safe to take with having osa?

Have you taken it?

Thanks for your help

As you can see from the posts, drugs have possible benefits and possible dangers. Questions of drug risk and safety can depend on your personal medical history. Some here have posted that they have found that their drug needs have changed dramatically once they begin to see the benefits of successful PAP therapy. Your sleep doc needs to know about your drugs, and the prescriber of your drugs, if not the sleep doc, may need to get a heads-up from you about your starting PAP therapy. Some have found that their dosage needs change or that a milder drug might now work better for them if their sleep and breathing are being effectively normalized with PAP. A few have been helped by their doctors to slowly come off benzos and SSRIs if their PAP therapy begins to lessen their needs for them. Others find they still need those medicines but dosage needs change. It is a highly individual thing. It isn't an odd thing to happen. Some have even come off blood pressure meds under their doctor's supervision too because of PAP.

So keep your doctors in the loop in the same way you would starting any new health-related therapy, like starting an exercise program or drastically changing your diet.

I greatly admire ozij's long tradition of passing on warnings of general drug dangers without giving medical advice, especially when posters, such as you, ask for that exact information. I also admire her skill at it. I have never seen her be the least bit alarmist about such matters. Including this time. So be sure to check out the link she provided thoroughly.

jeff