Xanax (for Panic Attacks) + CPAP

I searched the board and found some threads saying that most people do well with Xanax and CPAP therapy. Let me share last night's experience with you.

Yesterday, after two months of being in the clear.. WHAM! Panic attack. A bad one, too. It wasn't so intense, but it lasted for hours, and I think I had two back-to-back. Basically, from 9:30 am to 4pm, I was in some state of panic or anxiety. I called my doctor, instead of rushing to the ER, and he called in a low-dose prescription (0.5 mg) for Xanax. After work, my wife and I took a small walk, and then picked up my prescription. After, I took half (0.25 mg) at around 9 pm, and it really took the edge off.

Xanax stays in the body about 3-4 hours.

I got ready for bed, put on my new PapCAP, loaded up my Pur-Sleep scent and settled in. I just couldn't fall asleep. It took me an hour, possibly more, to fall asleep. I woke up again shortly thereafter, looked at the numbers and my AHI was like 15! I felt like the pressure was not nearly enough for me, so I upped the minimum pressure from 12.8 to 13.2, and it was good. I fell asleep, and my numbers this morning were good, but not great.

AHI was 5.
AI was 0.8 (usually <0.5).
HI was 4.2.

So, for me... if I absolutely have to take a Xanax close to bed time... I have to up the pressure! I'm not crazy about taking a med like Xanax, but on rare occasion, it does help the anxiety just not the apnea.

I had the same experience....AHI well above my norm when I took Xanax.

benzodiazepines are like alcohol they will make your apnea worse.

You said it yourself that you have gone months without an attack so you know the CPAP treatment must be working. I have noticed the same with regards to my anxiety. If I have a not so good nights sleep then i notice the anxiety increases.

My approach is to use drugs when needed and don't try to be bad or feel weak about having to use drugs, I accept that I will have good days and days and i try not to beat myself up on bad days.

I have heard from other people that they actually prefer to take a xanax before bedtime as it helps them relax and sleep as it slows down the cingulate (gear shifter of the brain).

jskinner wrote:benzodiazepines are like alcohol they will make your apnea worse.

I hear this but in my case i actually get a full nights sleep and better numbers if i have alcohol before bedtime. If i don't i generally wake 2-3 times and get really bad numbers. I wonder why ?

Because alcohol is a depressant, and your whole system (including respiration) will be 'depressed' if you drink it and then go to sleep (rather than 'working it off' somehow). I think using Xanax can be a slippery slope - it is addictive and while you may have a lousy time during a panic attack, might it not be better (if they're so rare anyway) to just live with them and not get sucked into 'allowing' yourself to use them (which is likely to happen more and more)?

Julie wrote:Because alcohol is a depressant, and your whole system (including respiration) will be 'depressed' if you drink it and then go to sleep (rather than 'working it off' somehow). I think using Xanax can be a slippery slope - it is addictive and while you may have a lousy time during a panic attack, might it not be better (if they're so rare anyway) to just live with them and not get sucked into 'allowing' yourself to use them (which is likely to happen more and more)?

I agree with you, and I was hesitant to take it. However, I need to function. I need to work. I need to keep my job.

I don't plan to take the Xanax unless I really feel a panic attack coming on. If they are that rare, I shouldn't need to take them with any great frequency, thus lessening my chance of dependence. I'm not crazy about it, but on those days that it happens, I may need something (in addition to my therapy and exercises) to help keep me going.

Have or did you try other forms of therapy first? Lots of people with anxiety have had a great deal of success with yoga and/or meditation.

SheZAAM, I am currently seeing a therapist that does Cognitive Behavioral Therapy, which includes visualization, deep breathing exercises, and exercises where I practice changing my attitude.

Really, for me the Xanax is just a stop-gap for emergency situations, not a long-term solution. Believe me, it look many panic attacks before I finally agreed to get the Xanax. I am just going to be VERY sparce about its usage.

Kenny, I think you have a good attitude about it. Use it when you really need it, when all else fails.

My husband and son were gone for 4 nights last week. My first time alone in the house which is a lot bigger since our remodel. I took 1 xanax every night before bed to help with my anxiety over being alone (I feel silly saying that, but it's the truth). I slept great! My numbers were exactly the same as usual (AHI usually below 1.9). When he got home I stopped taking them. The first night he was home I had a tough time falling asleep and staying asleep, but since then, no problems.

tattooyu wrote:SheZAAM, I am currently seeing a therapist that does Cognitive Behavioral Therapy, which includes visualization, deep breathing exercises, and exercises where I practice changing my attitude.

Really, for me the Xanax is just a stop-gap for emergency situations, not a long-term solution. Believe me, it look many panic attacks before I finally agreed to get the Xanax. I am just going to be VERY sparce about its usage.

Excellent! Cognitive therapy is my favorite. (I'm a therapist). It works so well in a relatively short term.
Better than all that feelings mumbo-jumbo.

Hi all,

Xanax doesn't cause dependency (or addiction) when it is taken only "prn" as needed (occasionally rather than daily). But when taken every day, you need to "taper off" gradually to avoid rebound anxiety. (Much like the need to taper off steroids).

I introduced physicians to Xanax when it first came out (working for the manufacturer). In following up over the years, and keeping up with the medical literature . . . it became clear to me that patients who got into trouble were these:

* those whose physician prescribed it inappropriately (wrong patient - ie, addictive personality- ; wrong dosage; wrong combo of meds, etc);
* those who drank alcohol or took other drugs that enhanced its activity or interacted with it;
* patients who stopped it abruptly instead of tapering off it slowly as the physician should have carefully instructed (to prevent "rebound anxiety")
* people who acquired it illegally & intentionally for it's "street value" abusing it.

So whenever you take Xanax, even "occasionally", don't take it with other psychotropic drugs, and don't drink alcohol while on it.

Joy

Kenny, the fact that you only needed 1/2 the prescribed dosage to settle you down is good, and if that's what you need once in awhile, not so bad. I know about panic attacks, they're no fun. I've had to take Ativan in half doses occasionally over many years(with Dr's OK) when I feel an attack coming on, and have not developed a dependence. You're a smart guy and seem to know what you're doing.

Thanks, Joy. You're a doll!

Since I do take it "prn" (I learned a new term!), I feel better about that. Still, I want to minimize its use as much as possible. I don't think I fall into any of those asterisked (*) categories, so I should be okay. I'm just glad that I'm at a lesser (or zero) risk of rebound anxiety.


DoriC, that's good. I'm a very NON-addictive person--well except for CPAP--but I can be a bit OCD, so I hope it's okay. With the half dose I felt fine. Not drugged, and not edgy either.

tattooyu wrote: Since I do take it "prn" (I learned a new term!), I feel better about that. Still, I want to minimize its use as much as possible. I don't think I fall into any of those asterisked (*) categories, so I should be okay. I'm just glad that I'm at a lesser (or zero) risk of rebound anxiety.

I took Zanax occasionally for anxiety during a period when I had a neurological infection that impacted my mood. I was able to take it as often as I needed, which was never very often, or at high doses. I had no trouble stopping it. In fact, I hardly noticed I stopped. I just forget to take it, as I wasn't anxious anymore.

While I don't necessarily recommend you take lots of it, don't withhold it from yourself too much. Just trying to figure out when things are bad enough to have to take it can cause more anxiety. Reassuring yourself that you will take care of yourself, even when it means taking medication, can go a long way towards calming the mind, which in turn helps the body be calm. You would have to take low dose Zanax fairly regularly, over a good period of time, to become dependent. I'm guessing you would have time, before that happened, to discuss it with your doctor or therapist.

I have read some of your threads, and you mentioned food sometimes causing symptoms. I also found that dehydration could raise my heart rate, drop my blood pressure, and cause anxiety. For a while I actually had to drink salt water (not REALLY salty)to raise my blood pressure, because otherwise I just couldn't stay hydrated. I learned that many people don't drink enough fluids, or drink too much with caffeine (which causes dehydration.) This may not be an issue for you, but I still drink extra water if I start to feel anxious, and it usually fixes things right up!