Xanax lowers my AHI?

[absolutscharf]

Came here (after being offline for a while ) to do a search for Xanax, but all I could find was related to its effect of helping people fall asleep/tolerate CPAP better. And I found a post about alcohol and AHI, from which I borrowed the subject line...

I've been on CPAP for about 4 months now, with a very supportive primary care physician and essentially non-existent DME/Sleep lab/doc support (although my DME seems to be the only one in the US who sells the F&P analysis software to their patients).

For the first two weeks, my AHI swung wildly (anything between 4 and 15), then settled to an average of around 10. Talked to my primary physician after the first month, and we agreed to increase the pressure slightly and follow the results. AHI immediately went down a notch and now averaged around 7 (rarely a night below 5). No other changes have been made to the pressure settings since then (since I had other things on my mind - see below).
I never had problems falling asleep or staying asleep (I use a Zeo sleep monitor), or tolerating the full face mask (after the initial period of figuring out how to best deal with it), and never took nor requested any medication to help me sleep.

About 4 weeks ago, the stress level in my life increased to the point where I had to ask my primary care physician for help, and he prescribed 1 mg Xanax twice a day. After acting like a Zombie at work, we quickly reduced it to 1/2 mg in the morning, and 1 mg at night, and it took care of my stress/anxiety very nicely.

Yesterday, I looked at the downloaded data from my machine for the first time in about 6 weeks (as I said, I had had other things on my mind, and the initial excitement of getting up in the morning and immediately looking at the previous night's data had long since disappeared). To my surprise, there was a significant and spontaneous drop in AHI from the usual 7-ish average to pretty consistent values of around 3 (never went above 5) at some point during the period I was looking at. And, guess what - that spontaneous drop coincided EXACTLY with the first night when I took 1 mg of Xanax before going to bed (double checked with the "filled on" date on the pill bottle).

Now, I concede that my "dialing in" period wasn't done yet, that my pressures weren't optimized, and that an average of 7 is not a desirable AHI endpoint, so clearly more attention should have been paid (by me - my DME apparently only looks at the compliance data) to the pressure settings. But it's the immediate and significant reaction of my AHI to the Xanax that really surprised me. Since I don't intend to keep taking that stuff indefinitely (but right now I still need it), I will closely monitor (and report) my AHIs once I get off of it.

Any thoughts or similar observations? Not really asking for help this time, just reporting something that I thought was odd...

Ron

[Lizistired]

I don't know, but Napstress(i think) and I were discussing this in another thread. She said she took Xanax during her titration and they were not able to achieve REM. Not clear that was the reason...
Do you notice a cooresponding difference in the way you feel?
It seems that if you tend to have more event in a particular sleep stage, like REM, the Xanax may interfere with sleep stages which should result in fewer events... or not. As we are all wired a little different.

How do you like your Zeo??

[DocWeezy]

You say you use a Zeo? What does your Zeo data say about the nights taking Zanax? How are your REM and deep sleep percentages? Any changes from pre-Xanax?

I use a Zeo too (love it!). For me, I've noticed a change in my sleep architecture when I'm taking heavy pain pills (fortunately a fairly rare occurrence), or a little too much wine (more than one glass) too close to bedtime. My AHI is always lower (at 0) these nights, but my Zeo shows greatly reduced REM and deep sleep stages. My hypothesis is that the drugs/alcohol impact my sleep to where I don't get as much of the good stages of deep and REM, and since that is when most of my apneas occur, my AHI is lower.

In other words, I'm sleeping much more lightly so I just don't have as many incidents. My incidents tend to occur in deep and REM sleep stages, not the light sleep stage.

Through trial and error and using a Zeo, I've discovered that having an AHI of 0 does not necessarily mean I feel great the next day--it usually means the opposite because I didn't sleep very deeply and sleep architecture was messed up. My BEST days have an AHI of about .7 to 1.2 the night before because nights with that AHI usually shows really good percentages of deep and REM sleep.

Bottom line: I feel better with higher percentages of deep and REM sleep; that also means my AHI is above 0. An AHI of 0 means I had a night of light sleep, and I don't feel very rested the next day.

Weezy

[absolutscharf]

*Love* my Zeo, but haven't looked at the data lately (as I said - too much other cr*p going on in my life). But what you say makes perfect sense to me, Weezy - lemme check!

[Mary Z]

I was told that many drugs have an unknown effect on sleep architecture, as has already been mentioned. This certainly could have an effect on your AHI.
The effects of many drugs on sleep has not been studied. I used to think about respiratory depression before It was explained to me about sleep architecture.
I take klonopin and do not find it has any effect on my numbers.
Interesting.

[purple]

I took Xanax before sleep therapy back many years ago. I loved it. Then doc says, it is the type of drug which can be addicting, no more Xanax for me. I might not have been hooked, but quitting Xanax was an experience which led to less sleep.

Was I told wrong, is Xanax not addictive, and how long can you take it.

[absolutscharf]

You say you use a Zeo? What does your Zeo data say about the nights taking Zanax? How are your REM and deep sleep percentages? Any changes from pre-Xanax?
Weezy

I *think* (it's not immediately obvious) that my sleep scores are a few points lower than they used to be since I started taking Xanax (I see high 60s more often now, where before I typically was always in the mid 70s). Couldn't say that I get less deep or REM now than I did before, but also haven't really done any regression analysis (which I could do, I'm just not sure I want to - enough math on the job already...).

[absolutscharf]

Was I told wrong, is Xanax not addictive, and how long can you take it.

As far as I know, it *is* addictive (which is why it's on the list of controlled substances). My physician prescribed a 6 month supply (1 month, 5 refills), which surprised me (because he knew, from how I described my situation to him, that this was only temporary). I would assume, though, that if I came back after 6 months and wanted more, he wouldn't prescribe it.

In any case, I''ll probably stop taking it anytime soon now (situation has resolved itself, as expected). I'm curious to find out what will happen to my AHI and sleep architecture once I get off of it.

[Julie]

It is definitely addictive, and while your AHI might be lower now (you're obviously more relaxed, if nothing else), you will need more and more to achieve the effect in future and it could also backfire by possibly even suppressing REM sleep in future, which you need. Ambien is a better idea, at least on a temporary basis.

[DocWeezy]

I *think* (it's not immediately obvious) that my sleep scores are a few points lower than they used to be since I started taking Xanax (I see high 60s more often now, where before I typically was always in the mid 70s). Couldn't say that I get less deep or REM now than I did before, but also haven't really done any regression analysis (which I could do, I'm just not sure I want to - enough math on the job already...).

Regression? I'm not that ambitious either. I just go onto the website, upload my data, and check the REM and deep sleep percentages. Someday when I have time (yeah, right...) I'm going to download it all into Excel and then do a bunch of charting because I also keep a separate sleep diary where I note various things like nighttime pain levels, etc. It was also a real eyeopener for me to see how lightly I slept and how often I woke up on the pain pill nights. No wonder I always felt crappy the next day! For me, just knowing the percentages of the sleep stages and seeing the changes on nights when I've had to take a pain pill really opened my eyes to what good sleep is. I used to think it was just being unconscious and unaware until the next morning was good sleep; now I know it is so much more and sleep architecture is important.

Weezy