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WHY YOU CAN’T STAY AWAKE: MANAGEMENT OF APNEA

As we saw in the previous chapter, the options for drug therapy in the treatment of sleep apnea are few and relatively ineffective. Some drugs may be appropriate when central apnea is the problem, since they act to repair the mechanisms responsible for a malfunctioning respiratory drive. Protriptyline, for example, stimulates the muscles of the upper airway; it also decreases the time spent in REM sleep, thus minimizing the periods during which most severe OSA occurs. In OSA, however, the causes of the breathing disruption are usually of a physical nature, making drug therapy largely useless. Sleeping pills, commercial or prescription, are no solution. I have discussed the fact that use of sedatives may produce sleep but can also act to prevent the sleeper from waking up enough to begin breathing after an apnea attack. What’s more, such drugs suppress respiratory function even further—in some cases to the point of death.
By the same token, however, to delay treatment, or avoid it entirely, may be just as dangerous. Besides the health risks posed by apnea, such as hypertension and heart disease, there is the documented danger of death directly attributable to breathing problems.
There are options, however, which can provide varying measures of success but, like almost any medical treatment, have their share of drawbacks as well. As we have seen, most apnea is really a mixture of CSA and OSA. Thus the discussion of treatments here will focus on the latter, since in many cases remedying the obstruction will subsequently eliminate the cause of central apnea as well.
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Posted on Thursday, January 27th, 2011 at 2:09 pm and is filed under Anti Depressants-Sleeping Aid. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.

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