Titration test necessary?

Ron AKA wrote: ↑

Fri Apr 06, 2018 4:26 pm

Central apnea is caused by issues with the autonomic nervous system. If you take something that affects the way the autonomic nervous system works, you can potentially influence the incidence of central apnea. No I have not done specific research on it, I was just saying it could be an issue. I guess if it is prescribed as a matter of routine when sleep tests are done, then perhaps someone has actually researched it and eliminated it as a complicating factor. I was not prescribed any when I did my sleep test.

I actually had a chance to discuss with my sleep doctor (who routinely writes the RX for Ambien when she orders the sleep study) the use of Ambien for some sleep maintenance insomnia issues secondary to arousals from pain and difficulty getting back to sleep because of the pain. She said she was a lot more concerned with muscle relaxers before even opiates or RX sleeping aids like Ambien or one of the others.

The RX sleep aids like Ambien...not known to be particularly bad for causing the problems that in turn cause centrals to pop up in some people. Not saying it would never happen but it would be really rare and more likely if used in combination with something else more known to suppress respiration....and that's probably not a good idea anyway. Ambien and a good sizable dose of an opiate...a person could end up like Prince. As with anything a lot is going to depend on the dosage of either and especially combine.

But the RX sleep meds all by themselves....not really known to cause centrals by suppressing respiration in the normal healthy population. If they were they wouldn't be so widely prescribed both for known sleep apnea diagnosed patients and people without sleep apnea.

The end result for me was she had no problem prescribing Ambien to help me sleep through the pain...sleep a little deeper so less chance of the discomfort causing an awakening...and had no problem prescribing it long term as long as I knew the risks.
There's always a risk vs rewards thing with any medication out there. I didn't use it every night though (didn't want to get dependent) and I would cut the pill in half or thirds often to reduce the dosage.

As with any of these type of meds...always discuss them with your doctor who has complete access to your health and medication history and make an informed decision if it is right for the patient's own situation.

Meds known to suppress respiration and cause centrals....depends on the dosage but mainly the pain meds in the opiod family....including the synthetics like methadone or whatever people are taking instead of the hard stuff.
An occasional hydrocodone type of pill...not usually that big of a deal.
Heck even when I had surgery for my broken arm and was eating Percocet like candy at bed time I didn't have any issues with centrals.
And currently take a low dose hydrocodone at bedtime for the pain issues (not with the Ambien though) and I rarely have a central at all and if I do it's most likely SWJ or sleep onset.