Hypopnea & klonopin correlation

[Dogjudge]

This is more curiosity than anything else.

Elsewhere I've posted that I'm trying to eliminate my nightly use of klonopin. I'm going very slowly. Happen to see my GP the other day and mentioned this and he felt my program (-0.25 mg/month) was more than reasonable. I'm starting from 2.0 mg. Now down to 1.75.

Accidentally, I forgot to take the klonopin two nights in a row.

For me, if my hypopnea events are under ten, I'm getting a good night sleep. Even if I have one, or two apnea events.

Well, the accident was enlightening.

Last day with medication. AHI was under 1 with 8 hypopnea events, no obstructive events. First night where I forgot hypopnea went to 18 events with an AHI of 2.41. The second night was even more interesting to me. Hypopnea events went to 39 and AHI went to 5.3.

Back on klonopin last night. Hypopnea was down to 11, with an AHI of 1.4.

I realize that simply going off klonopin completely is dangerous, etc. and I wasn't trying to do this.

Anyone know why klonopin would reduce hypopnea events?

[CaptainRaven40]

I do not know the reasoning behind this but I did take klonopin for a very long time to help with my seizure disorder. This is a question for a medical professional for sure.

[jagzoo]

Interesting report.

Think it gives a reason for all who think that taking any of the seizure/ anxiety reducers/ sleep enhancing meds worsens Sleep apnea I.e. AHI to rethink. I know that if I forget to take my Aprazolam ( Zanax) for my RLS, my AHI is increased (with no increased leaks). I will continue to take it - and I sleep with fewer arousals.

There are very few hard and fast rules - each person needs to find out what works for them!

[qbquixote]

There are a couple different things going on with clonazepam, and for sure we don't don't everything about it, its a little bit of a muscle relaxant itself, but I would guess suppressed REM and reduced REM based paralysis and airway collapse could be a cause of increased hypopnea. Were most of the hypopneas in the second 1/2 of the night?

Burt

[qbquixote]

Sorry that came out slightly wrong - I was on the telephone when I was typing.
Clonazepam suppresses REM. Immediately after you stop clonazepam there is benzodiazepine withdrawal REM rebound and hence more paralysis and possible related increased hypopnea. Given time off the clonazepam this effect would decrease and might lower your hypopnea again.

There are so many personal factors though. I'll be interested in what the experts on the site have to say.

Burt

[Dogjudge]

Thanks for the comments about how it functions.

It was just that the change was so dramatic, and it was simply one item that had changed to any degree and it had changed significantly.

Still going to stick to my original plan to try to wean myself off the stuff. Two steps forward, one step back.

[qbquixote]

Sure,

I hope that works well for you.
Slow weaning theoretically should minimize some of the extra rebound.
Some people move more as well coming off the clonazepam, (it treats RLS), I guess that can lead to more mask leaks.
I am pretty new to CPAP personally, but have some experience with clonazepam and sleep.

Be well,

Burt