Cymbalta vs. Cipralex and Sleep Apnea

[JMG]

Hi all,

Been away from here for a long time! Haven't been using my machine at all for a long time. Big sinus issues, and other troubles (it's complicated....really complicated!)

Anyway...Because of side affects from Paxil that just were a "no-no" (to me) with sleep apnea, I've decided to switch to a new med. (Been on Paxil for 14 years). The specific side effects from Paxil that just aggravated my sleep apnea (and symptoms) were Drowsiness, Fatigue and a general Sedative effect (as in relaxed muscles). The sedative effect almost certainly relaxed my throat muscles even more, leading to more apneas. And of course, already super drowsy and fatigued from sleep apnea, so totally compounded by the med's side effects. (The sleep apnea was only diagnosed 5 years ago, BTW).

So my doctor has suggested trying either Cymbalta or Cipralex as a replacement to the Paxil. And I'm reading the side effects and a lot of them are the same as with Paxil.

Here's my question: If you are on an AD, which AD has been the least aggravating of your sleep apnea?? Which has been the most?

Anyone else switched meds due to drowsiness caused by the med making sleep apnea issues worse?

Any insight/links appreciated.

[SleepingUgly]

SSRIs can impact sleep architecture. I'm not sure if Wellbutrin has any deleterious effects on sleep, although in extended release formulation, it could cause insomnia. So I don't think it would cause sedation, but I don't know if it would exacerbate limb movements or anything like that (don't know if that's an issue for you anyway). Not sure if relaxing of the muscles effect has been studied.

[JMG]

Limb movements are not an issue. Actually, a problem I have is that I go to sleep on one side (left for instance) and I wake up (in the morning) on exactly the same side. My left thigh is usually numb because I literally haven't moved all night. And I have deep creases on my skin from lying on the sheets in the same position for so long. I only turn over if I wake up fully.

I've read some articles on the dangers of general anaesthetic during surgery and how if you have sleep apnea you must tell the anaesthetist because the anaest. drugs cause such sedation (obviously!) that you can't wake yourself to resume breathing.


ETA: here's a link http://www.sleepapnea.org/resources/pubs/treatment.html that talks about central nervous system (CNS) depressants (e.g. muscle relaxants) exacerbating things.

[SleepingUgly]

I've read some articles on the dangers of general anaesthetic during surgery and how if you have sleep apnea you must tell the anaesthetist because the anaest. drugs cause such sedation (obviously!) that you can't wake yourself to resume breathing.

ETA: here's a link http://www.sleepapnea.org/resources/pubs/treatment.html that talks about central nervous system (CNS) depressants (e.g. muscle relaxants) exacerbating things.

I just read something the other day about SSRIs increasing upper airway patency in NREM sleep or something. I was googling medications and REM-dependent OSA, because I was wondering whether medications that suppress REM have been studied as a treatment for REM-dependent OSA. I came across literature about SSRIs (which tend to suppress REM) actually decreasing events in NREM (can't remember why in NREM--it was a surprising finding) and something about upper airway patency. In any event, I think you were just looking for a nonsedating antidepressant, right? I think you want an antidepressant that has the least negative impact on sleep architecture.

[JMG]

correct.

I will have to Google some of those terms you just threw at me...but time for bed first. Back tomorrow.

[TheTwinsMom1]

I take cymbalta in the morning for chronic pain. For me it caused sleeplessness when I took it at bedtime. So we switched to taking it in the morning and I am not having any sleep side effects from this med.

[JMG]

Thank you TheTwinsMom! Good to know.

I found the article on SSRI's and patency. VERY interesting. I had no idea.

[roster]

Any insight/links appreciated.

Here is an insight: You are paying good money and all you are achieving is bad side effects and high drug company stock prices.

Try this:

1. Make sure your CPAP therapy is effective by using a good data-capable machine and tweaking as necessary.
2. Have a reasonable, consistent exercise routine.
3. Enjoy an excellent diet.
4. Practice strict sleep hygiene.
5. Foster good, close relations with friends, associates and family.
6. Put the drugs in a brown paper bag, mark it "Failure" and put the bag in the bottom back corner of a cabinet.

[JMG]

God love ya roster. Sorry meds are such a threat to you. I think you need to open up your mind a little.

[roster]

God love ya roster. Sorry meds are such a threat to you. I think you need to open up your mind a little.

What about you? Start with 1 - 5.

[Jae]

Oh dear where do I start I am a 41 year old female and was diagnosed with PTSD have been on cymbalta since July 2011 and have just recently had to go to a sleep clinic for the first time in my life due to snoring, my results have come back as moderate obstructive sleep apnea and restless legs, apparently for the first half of the night I had moved my legs 257 times whilst sleeping, snoring started soon after administration of cymbalta 60 mg and weaned very slowly down to approx 15 mg and sleep apnea and restless legs have suddenly stopped. I have aged so much over the past 9 months due to lack of sleep, I was constantly fatigued, irritable. I will never go on cymbalta ever again!!!!!!

[chunkyfrog]

An individual's response/reaction to a drug may changeover time--or even suddenly.
It is always a good idea to be conservative, and involve all your medical providers.

[avi123]

I been on daily 10 mg Paxil for almost 20 years. I started after a psychiatrist told me that he takes it to be able to take all the mess around him. And he, at that time, happened to be a dept. chief in a nationally reputable hospital. So he prescribed it for me too. I don't notice that it affects my sleep even if my Sleep Doc wrote in the PSG report that it delays REM sleep. I also take Xanax as anti anxiety. Recently, my internist said that I could replace the Paxil, Xanax, Gabapentin, and the NSAID that I take, with Cymbalta, and he even gave me free samples. But checking the side effects of Cymbalta, and the price (that would not be covered by my Medicare part D), I said thanks. Not now. I am not familiar with the other Rx in your question. How have you withdrawn from Paxil after 14 years?

Roster, thanks for stopping the jumpiness of the Rooster in your Avatar!

[Sparky223]

I can not say for sure its the cymbalta for sure, but since on it my AHI has increased and my 90% pressure has increased alot.