Table of ContentsView AllTable of ContentsAntidepressantsAntihistaminesBenzodiazepinesOpiatesBarbituratesBaclofenTestosteroneMedications Causing Weight GainAlcoholWhat to Consider Before Taking These Drugs
Table of ContentsView All
View All
Table of Contents
Antidepressants
Antihistamines
Benzodiazepines
Opiates
Barbiturates
Baclofen
Testosterone
Medications Causing Weight Gain
Alcohol
What to Consider Before Taking These Drugs
This article will discuss the medications that can affect sleep apnea and which ones to avoid to prevent worsening the condition.
Research suggests that there may be an association between impaired breathing and inadequate nighttimeoxygen saturationand selective serotonin reuptake inhibitors (SSRIs), a type of antidepressants that may possibly make sleep apnea symptoms worse.
However, mirtazapine and trazodone are two antidepressants that research suggests may reduce sleep apnea severity.More research is needed in this area to conclude whether and which antidepressants make sleep apnea worse.
Antihistamines are a class of drugs commonly used to treatallergy symptoms. The immune system releases the chemical histamine to help get rid of foreign invaders that find their way into the body.
Allergy symptoms such as coughing and sneezing occur when histamine is released in response to exposure to harmlessallergens. Antihistamines, which can be bought over the counter, work to lessen these effects.Some common antihistamine medications include:
Antihistamines are also sometimes used as sleeping aids. However, American Academy of Sleep Medicine guidelines note there is limited evidence of their benefit and they may present risks when used as sleep aids.There is no clear evidence of their effects in people with obstructive sleep apnea, although they may contribute to weight gain, a known risk factor for sleep apnea.
Can Antihistamines Like Allegra and Zyrtec Cause Weight Gain?
Benzodiazepinesare a class of prescription medications used to relieve anxiety. Some work as muscle relaxants or are used as anticonvulsants to treat seizures. As these medications can also cause sleepiness, they have sometimes been used over the short term to aid sleep. However, chronic use for this purpose is discouraged due to their high risk of dependency.
Benzodiazepine medications include:
Two of these drugs, flurazepam and triazolam, lowered oxygen saturation at night during research studies.However, other studies of benzodiazepine drugs have not found significant effects. While there may be a relationship between the drugs and sleep apnea symptoms, more data is needed.
Opiates (sometimes called opioids or narcotics) are a class of prescription medications often used to treat pain and sometimes diarrhea or cough.Opiates can cause sleepiness but also affect breathing during sleep. Some of the common opiates include:
These opiates bind to various opioid receptors within the nervous system and elsewhere in the body, resulting in increased respiratory pauses, irregular breathing, and shallow breaths. Like benzodiazepines, opiates may relax the muscles in the upper airway, leading to a blockage. They also may interfere with signals to the muscles that involve breathing.
People who are taking opioids for chronic conditions, like cancer or chronic obstructive pulmonary disease (COPD), may be more at risk of sleep apnea complications.More research is needed to understand opiate effects and the type of sleep apnea that may be at work.
Barbituratesare a class of prescription medications that cause sedation. They used to be used as a sleep aid, but have been largely phased out because of serious side effects, including the risk for dependence, withdrawal, and coma. Today they’re largely used to treat seizures. Some barbiturates include:
Barbiturates act at the sodium and potassium transporters in cells, inhibiting thereticular activating systemin the brainstem—a system responsible for regulating sleep-wake transitions. This can produce sedation and even coma and has significant effects on breathing.
Baclofen, a myorelaxant (skeletal muscle relaxant), is used to treat spasticity in conditions like multiple sclerosis and spinal cord conditions. These relaxant properties are thought to cause upper airway collapse during sleep, increasing the incidence of sleep apnea.
Studies have found that central sleep apnea (not obstructive) has been reported with long-term use of baclofen at high doses in people diagnosed with alcohol use disorder. There’s also some evidence of central sleep apnea at normal doses in people who have had a previous stroke. However, a single 25-milligram dose had no effect in studies of people with moderate obstructive sleep apnea.
Some researchers have recommended that people with obstructive sleep apnea avoid using baclofen.However, more data is needed to support conclusions about sleep apnea and the use of baclofen.
Research has found some evidence that testosterone can increase the cases of sleep apnea. In a 2018 study, the risk of sleep apnea was higher in patients takingtestosterone replacement therapy.
A 2020 review of studies concluded that testosterone replacement therapy is a risk factor for developing sleep apnea. It recommended that those receiving the therapy should be monitored for the condition, particularly in obese patients.
Certain medications can contribute to weight gain, increasing the risk for sleep apnea. About 70% of those with sleep apnea are obese.This can be the result of extra tissue blocking the upper airways.
Medications that can cause weight gain include antidepressants, anticonvulsants, alpha- and beta‐adrenergic blockers, diabetes medications, and antihistamines.
How Weight Loss May Improve Your Sleep
Alcohol’s sedative properties lead many to use it as a way to relax and fall asleep. However, research has shown that drinking alcohol before bed can negatively impact yournatural sleeping cycle. Alcohol also relaxes airway muscles, potentially triggering an apnea episode.
How Getting Sunlight in the Morning Can Help You Sleep Better
Before taking these medications, it is important to know if you have sleep apnea or are at risk of developing sleep apnea. Common risk factors include:
Talking to a healthcare provider can help you determine if the benefits of the medication outweigh the potential for harm in your situation. They may decide to treat the underlying causes of your sleep apnea, which may help you sleep better and eliminate the need for you to take some of the medications described above.
If you decide to take any of the medications described above, the effects can be monitored with apolysomnogram(PSG), also called a sleep study. During the study, electrodes placed on your body monitor your brain waves, breathing patterns, blood oxygen levels, and more.
Talk to Your Healthcare Provider About MedicationsSome medications may affect your breathing and increase the risk of sleep apnea. So can alcohol, which may help people to sleep but it is known to make sleep apnea symptoms worse.More research is needed, though, to understand these effects. Talk to your healthcare provider about medications you take and concerns about sleep apnea.
Talk to Your Healthcare Provider About Medications
Some medications may affect your breathing and increase the risk of sleep apnea. So can alcohol, which may help people to sleep but it is known to make sleep apnea symptoms worse.More research is needed, though, to understand these effects. Talk to your healthcare provider about medications you take and concerns about sleep apnea.
What’s the Link Between Alcohol and Sleep Apnea?
Summary
20 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.American Medical Association.What doctors wish patients knew about sleep apnea.Medline Plus.Obstructive sleep apnea - adults.Jullian‐Desayes I, Revol B, Chareyre E, et al.Impact of concomitant medications on obstructive sleep apnoea.British Journal of Clinical Pharmacology. 2016;83(4):688-708. doi:10.1111/bcp.13153Robillard R, Saad M, Ray LB, et al.Selective serotonin reuptake inhibitor use is associated with worse sleep-related breathing disturbances in individuals with depressive disorders and sleep complaints: a retrospective study.J Clin Sleep Med. 2021;17(3):505-513. doi:10.5664/jcsm.8942AbdelFattah MR, Jung SW, Greenspan MA, Padilla M, Enciso R.Efficacy of antidepressants in the treatment of obstructive sleep apnea compared to placebo. A systematic review with meta-analyses.Sleep Breath. 2020;24(2):443-453. doi:10.1007/s11325-019-01954-9MedlinePlus.Antihistamines for allergies.American Academy of Family Physicians.Anti-histamines: Understanding your OTC options.Sateia MJ, Buysse DJ, Krystal AD, Neubauer DN, Heald JL.Clinical practice guideline for the pharmacologic treatment of chronic insomnia in adults: an American Academy of Sleep Medicine clinical practice guideline.J Clin Sleep Med. 2017;13(2):307–349.Atkin T, Comai S, Gobbi G.Drugs for insomnia beyond benzodiazepines: pharmacology, clinical applications, and discovery.Pharmacol Rev. 2018;70(2):197-245. doi:10.1124/pr.117.014381Department of Justice Drug Enforcement Administration.Benzodiazepines.National Institute on Drug Abuse.What are prescription opioids.Centers for Disease Control and Prevention.Prescription opioids: The basics.Correa D, Farney RJ, Chung F, Prasad A, Lam D, Wong J.Chronic opioid use and central sleep apnea: a review of the prevalence, mechanisms, and perioperative considerations.Anesth Analg. 2015;120(6):1273-85. doi:10.1213/ANE.0000000000000672European Monitoring Centre for Drugs and Drug Addiction.Barbiturates drug profile.Heck T, Zolezzi M.Obstructive sleep apnea: management considerations in psychiatric patients.Neuropsychiatr Dis Treat. 2015;11:2691–2698. doi:10.2147/NDT.S90521Locatelli F, Formica F, Galbiati S, et al.Polysomnographic analysis of a pediatric case of baclofen-induced central sleep apnea.Journal of Clinical Sleep Medicine. 2019;15(02):351-354. doi:10.5664/jcsm.7644Straus C, Teulier M, Morel S, Wattiez N, Hajage D, Giboin C,et al.Baclofen destabilises breathing during sleep in healthy humans: A randomised, controlled, double-blind crossover trial.Br J Clin Pharmacol. 2021 Apr;87(4):1814-1823. doi: 10.1111/bcp.14569.Cole AP, Hanske J, Jiang W, et al.Impact of testosterone replacement therapy on thromboembolism, heart disease and obstructive sleep apnoea in men.BJU International. 2018;121(5):811-818. doi:10.1111/bju.14149La Vignera S, Calogero AE, Cannarella R, Condorelli RA, Magagnini C, Aversa A.Obstructive sleep apnea and testosterone replacement therapy.Androgens: Clinical Research and Therapeutics. 2020;1(1):10-14. doi:10.1089/andro.2020.0001Simou E, Britton J, Leonardi-bee J.Alcohol and the risk of sleep apnoea: a systematic review and meta-analysis.Sleep Med. 2018;42:38-46. doi:10.1016/j.sleep.2017.12.005.
20 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.American Medical Association.What doctors wish patients knew about sleep apnea.Medline Plus.Obstructive sleep apnea - adults.Jullian‐Desayes I, Revol B, Chareyre E, et al.Impact of concomitant medications on obstructive sleep apnoea.British Journal of Clinical Pharmacology. 2016;83(4):688-708. doi:10.1111/bcp.13153Robillard R, Saad M, Ray LB, et al.Selective serotonin reuptake inhibitor use is associated with worse sleep-related breathing disturbances in individuals with depressive disorders and sleep complaints: a retrospective study.J Clin Sleep Med. 2021;17(3):505-513. doi:10.5664/jcsm.8942AbdelFattah MR, Jung SW, Greenspan MA, Padilla M, Enciso R.Efficacy of antidepressants in the treatment of obstructive sleep apnea compared to placebo. A systematic review with meta-analyses.Sleep Breath. 2020;24(2):443-453. doi:10.1007/s11325-019-01954-9MedlinePlus.Antihistamines for allergies.American Academy of Family Physicians.Anti-histamines: Understanding your OTC options.Sateia MJ, Buysse DJ, Krystal AD, Neubauer DN, Heald JL.Clinical practice guideline for the pharmacologic treatment of chronic insomnia in adults: an American Academy of Sleep Medicine clinical practice guideline.J Clin Sleep Med. 2017;13(2):307–349.Atkin T, Comai S, Gobbi G.Drugs for insomnia beyond benzodiazepines: pharmacology, clinical applications, and discovery.Pharmacol Rev. 2018;70(2):197-245. doi:10.1124/pr.117.014381Department of Justice Drug Enforcement Administration.Benzodiazepines.National Institute on Drug Abuse.What are prescription opioids.Centers for Disease Control and Prevention.Prescription opioids: The basics.Correa D, Farney RJ, Chung F, Prasad A, Lam D, Wong J.Chronic opioid use and central sleep apnea: a review of the prevalence, mechanisms, and perioperative considerations.Anesth Analg. 2015;120(6):1273-85. doi:10.1213/ANE.0000000000000672European Monitoring Centre for Drugs and Drug Addiction.Barbiturates drug profile.Heck T, Zolezzi M.Obstructive sleep apnea: management considerations in psychiatric patients.Neuropsychiatr Dis Treat. 2015;11:2691–2698. doi:10.2147/NDT.S90521Locatelli F, Formica F, Galbiati S, et al.Polysomnographic analysis of a pediatric case of baclofen-induced central sleep apnea.Journal of Clinical Sleep Medicine. 2019;15(02):351-354. doi:10.5664/jcsm.7644Straus C, Teulier M, Morel S, Wattiez N, Hajage D, Giboin C,et al.Baclofen destabilises breathing during sleep in healthy humans: A randomised, controlled, double-blind crossover trial.Br J Clin Pharmacol. 2021 Apr;87(4):1814-1823. doi: 10.1111/bcp.14569.Cole AP, Hanske J, Jiang W, et al.Impact of testosterone replacement therapy on thromboembolism, heart disease and obstructive sleep apnoea in men.BJU International. 2018;121(5):811-818. doi:10.1111/bju.14149La Vignera S, Calogero AE, Cannarella R, Condorelli RA, Magagnini C, Aversa A.Obstructive sleep apnea and testosterone replacement therapy.Androgens: Clinical Research and Therapeutics. 2020;1(1):10-14. doi:10.1089/andro.2020.0001Simou E, Britton J, Leonardi-bee J.Alcohol and the risk of sleep apnoea: a systematic review and meta-analysis.Sleep Med. 2018;42:38-46. doi:10.1016/j.sleep.2017.12.005.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
American Medical Association.What doctors wish patients knew about sleep apnea.Medline Plus.Obstructive sleep apnea - adults.Jullian‐Desayes I, Revol B, Chareyre E, et al.Impact of concomitant medications on obstructive sleep apnoea.British Journal of Clinical Pharmacology. 2016;83(4):688-708. doi:10.1111/bcp.13153Robillard R, Saad M, Ray LB, et al.Selective serotonin reuptake inhibitor use is associated with worse sleep-related breathing disturbances in individuals with depressive disorders and sleep complaints: a retrospective study.J Clin Sleep Med. 2021;17(3):505-513. doi:10.5664/jcsm.8942AbdelFattah MR, Jung SW, Greenspan MA, Padilla M, Enciso R.Efficacy of antidepressants in the treatment of obstructive sleep apnea compared to placebo. A systematic review with meta-analyses.Sleep Breath. 2020;24(2):443-453. doi:10.1007/s11325-019-01954-9MedlinePlus.Antihistamines for allergies.American Academy of Family Physicians.Anti-histamines: Understanding your OTC options.Sateia MJ, Buysse DJ, Krystal AD, Neubauer DN, Heald JL.Clinical practice guideline for the pharmacologic treatment of chronic insomnia in adults: an American Academy of Sleep Medicine clinical practice guideline.J Clin Sleep Med. 2017;13(2):307–349.Atkin T, Comai S, Gobbi G.Drugs for insomnia beyond benzodiazepines: pharmacology, clinical applications, and discovery.Pharmacol Rev. 2018;70(2):197-245. doi:10.1124/pr.117.014381Department of Justice Drug Enforcement Administration.Benzodiazepines.National Institute on Drug Abuse.What are prescription opioids.Centers for Disease Control and Prevention.Prescription opioids: The basics.Correa D, Farney RJ, Chung F, Prasad A, Lam D, Wong J.Chronic opioid use and central sleep apnea: a review of the prevalence, mechanisms, and perioperative considerations.Anesth Analg. 2015;120(6):1273-85. doi:10.1213/ANE.0000000000000672European Monitoring Centre for Drugs and Drug Addiction.Barbiturates drug profile.Heck T, Zolezzi M.Obstructive sleep apnea: management considerations in psychiatric patients.Neuropsychiatr Dis Treat. 2015;11:2691–2698. doi:10.2147/NDT.S90521Locatelli F, Formica F, Galbiati S, et al.Polysomnographic analysis of a pediatric case of baclofen-induced central sleep apnea.Journal of Clinical Sleep Medicine. 2019;15(02):351-354. doi:10.5664/jcsm.7644Straus C, Teulier M, Morel S, Wattiez N, Hajage D, Giboin C,et al.Baclofen destabilises breathing during sleep in healthy humans: A randomised, controlled, double-blind crossover trial.Br J Clin Pharmacol. 2021 Apr;87(4):1814-1823. doi: 10.1111/bcp.14569.Cole AP, Hanske J, Jiang W, et al.Impact of testosterone replacement therapy on thromboembolism, heart disease and obstructive sleep apnoea in men.BJU International. 2018;121(5):811-818. doi:10.1111/bju.14149La Vignera S, Calogero AE, Cannarella R, Condorelli RA, Magagnini C, Aversa A.Obstructive sleep apnea and testosterone replacement therapy.Androgens: Clinical Research and Therapeutics. 2020;1(1):10-14. doi:10.1089/andro.2020.0001Simou E, Britton J, Leonardi-bee J.Alcohol and the risk of sleep apnoea: a systematic review and meta-analysis.Sleep Med. 2018;42:38-46. doi:10.1016/j.sleep.2017.12.005.
American Medical Association.What doctors wish patients knew about sleep apnea.
Medline Plus.Obstructive sleep apnea - adults.
Jullian‐Desayes I, Revol B, Chareyre E, et al.Impact of concomitant medications on obstructive sleep apnoea.British Journal of Clinical Pharmacology. 2016;83(4):688-708. doi:10.1111/bcp.13153
Robillard R, Saad M, Ray LB, et al.Selective serotonin reuptake inhibitor use is associated with worse sleep-related breathing disturbances in individuals with depressive disorders and sleep complaints: a retrospective study.J Clin Sleep Med. 2021;17(3):505-513. doi:10.5664/jcsm.8942
AbdelFattah MR, Jung SW, Greenspan MA, Padilla M, Enciso R.Efficacy of antidepressants in the treatment of obstructive sleep apnea compared to placebo. A systematic review with meta-analyses.Sleep Breath. 2020;24(2):443-453. doi:10.1007/s11325-019-01954-9
MedlinePlus.Antihistamines for allergies.
American Academy of Family Physicians.Anti-histamines: Understanding your OTC options.
Sateia MJ, Buysse DJ, Krystal AD, Neubauer DN, Heald JL.Clinical practice guideline for the pharmacologic treatment of chronic insomnia in adults: an American Academy of Sleep Medicine clinical practice guideline.J Clin Sleep Med. 2017;13(2):307–349.
Atkin T, Comai S, Gobbi G.Drugs for insomnia beyond benzodiazepines: pharmacology, clinical applications, and discovery.Pharmacol Rev. 2018;70(2):197-245. doi:10.1124/pr.117.014381
Department of Justice Drug Enforcement Administration.Benzodiazepines.
National Institute on Drug Abuse.What are prescription opioids.
Centers for Disease Control and Prevention.Prescription opioids: The basics.
Correa D, Farney RJ, Chung F, Prasad A, Lam D, Wong J.Chronic opioid use and central sleep apnea: a review of the prevalence, mechanisms, and perioperative considerations.Anesth Analg. 2015;120(6):1273-85. doi:10.1213/ANE.0000000000000672
European Monitoring Centre for Drugs and Drug Addiction.Barbiturates drug profile.
Heck T, Zolezzi M.Obstructive sleep apnea: management considerations in psychiatric patients.Neuropsychiatr Dis Treat. 2015;11:2691–2698. doi:10.2147/NDT.S90521
Locatelli F, Formica F, Galbiati S, et al.Polysomnographic analysis of a pediatric case of baclofen-induced central sleep apnea.Journal of Clinical Sleep Medicine. 2019;15(02):351-354. doi:10.5664/jcsm.7644
Straus C, Teulier M, Morel S, Wattiez N, Hajage D, Giboin C,et al.Baclofen destabilises breathing during sleep in healthy humans: A randomised, controlled, double-blind crossover trial.Br J Clin Pharmacol. 2021 Apr;87(4):1814-1823. doi: 10.1111/bcp.14569.
Cole AP, Hanske J, Jiang W, et al.Impact of testosterone replacement therapy on thromboembolism, heart disease and obstructive sleep apnoea in men.BJU International. 2018;121(5):811-818. doi:10.1111/bju.14149
La Vignera S, Calogero AE, Cannarella R, Condorelli RA, Magagnini C, Aversa A.Obstructive sleep apnea and testosterone replacement therapy.Androgens: Clinical Research and Therapeutics. 2020;1(1):10-14. doi:10.1089/andro.2020.0001
Simou E, Britton J, Leonardi-bee J.Alcohol and the risk of sleep apnoea: a systematic review and meta-analysis.Sleep Med. 2018;42:38-46. doi:10.1016/j.sleep.2017.12.005.
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