diazepam (Valium) = more apneas??

I am relatively new to CPAP (July 09) and have a question for those of you who know OSA much better than I.

I have fibromyalgia. One of the meds that has proven to be helpful in allowing my overly sensitive and very tense muscles to rest themselves is a nightly dose of diazepam (5mg). It is a muscle relaxant, but to a much milder degree than flexaril and others. My understanding is that any type of sedative/muscle realxer will worsen OSA because it relaxes esophageal muscles too. As a result, I gave up my nightly diazepam when I was diagnosed with OSA. Unfortunately, my fibro is not responding well to this particular change in meds.

What I'm wondering is this... As the diazepam likely exacerbates the apneas, could the CPAP (or in my case bipap) address them well enough to still allow me to use the medication safely? I know that the OSA can threaten my life whereas the fibro only lessens my quality of life, but both are important to me. In over 12 years of ever changing fibro meds, diazepam is one that we always keep. We just haven't found anything that allows my tender muscles to rest themselves as well without over-sedating.

BTW- since beginning therapy is avg AHI-8.4, AI- 3.4 (resmed numbers). I haven't added the diazepam back yet, so no data on that.

Any thoughts would be appreciated,
-Kim

I just asked a similar question of my sleep doctor today about my Panic Disorder.

Can taking an SSRI, such as Zoloft or Lexapro, on a daily basis interfere with sleep architecture or cause increased relaxation of the airway during sleep?

Possible REM supression; will not relax airway.

Can taking a Benzodiazepine, such as Klonopin [or Valium], on a daily basis interfere with sleep architecture or cause increased relaxation of the airway during sleep?

Possible REM supression; may relax airway, retitration possibly needed.


If you do need to take them for your fibromyalgia, it seems you may need a higher pressure to catch more of the events that may occur.

Hi Kim,
My sleep doctor tells me, providing sedatives to patients, is like giving them poison if they have apnea. He explained in great details why & told me, I could find further information on the internet.

I honestly don't know, if I should post this here, but Klonopin contributed to worsening my apnea. Throat muscles were damaged (weakened), thyroid enlarged, and the list of damage goes on.

But there is good & bad side to every story. Many people have taken sedatives with positive results.

If you've experienced positive results, from meds/apnea treatments. I would follow the instructions of your physician, whom can provide the best advise & treatment, concerning your health issues.

tattooyu wrote:Can taking a Benzodiazepine, such as Klonopin [or Valium], on a daily basis interfere with sleep architecture or cause increased relaxation of the airway during sleep?

Possible REM supression; may relax airway, retitration possibly needed.


If you do need to take them for your fibromyalgia, it seems you may need a higher pressure to catch more of the events that may occur.

It seems that way to me as well. I'll be seeing the sleep doc on the 22nd and was planning to ask. But that seems so far away when I feel so achey. My bipap is auto-adjusting. Maybe I could add back the diazepam and "re-titrate" at home between now & my appointment.
-K

I will agree that a higher pressure might be needed. I say give the med a try but it would be more helpful if you have the software so you can see how or if you are having a cluster of events, etc.

Spirit,

The analogy of sedatives=poison for an apnea patient does make sense to me- just on a logical level, without even having data & explanations. I am more concerned with preserving my life than my comfort, but if there is a way to do both...

Gumby,
I have the software, card reader is on its way. I'm sure I'll need help interpreting the data, but I know there is plenty of that to be found here.

Thanks,
Kim

I have begun research on low-dose naltrexone.

It's not something you will hear much about because it isn't under patent, and thus Big Pharma has no interest in conducting studies to determine effectiveness.

While some folks swear it will cure everything, I am less sanguine on this. However, what I have seen so far of it, and based on reports from people whose opinions I trust, it has significant promise.

MS is one of those things it seems to work for.

magentapolkadots wrote: The analogy of sedatives=poison for an apnea patient does make sense to me

Hi Kim,
Sorry, if I shared any discomfort to you. What is important, is living a happy, fufilling life. And as I shared, if meds/apnea treatments are working for you, then I would continue this course, with the advise of your physician.

I am not here, to discourage anyone from proper treatment, only sharing my experiences, and as I shared many have had positive experiences.

The way I see it is, the higher the dose, the stronger the pressure. Then it's obvious, sedatives contributes to further relaxation of the throat.

Good luck to you ! Sleep well !

I guess my questions are, how long have you been taking the valium, before you were diagnosed with SA? Were you taking valium when you did your sleep study? Can you tell if there is a difference in your breathing when sleeping, which may be hard to tell because of using a cpap. I think if this works for you that you should continue to take the med. Pain plays a major roll in getting a good nights sleep too.

Rosie

Kiralynx wrote:I have begun research on low-dose naltrexone.

It's not something you will hear much about because it isn't under patent, and thus Big Pharma has no interest in conducting studies to determine effectiveness.

While some folks swear it will cure everything, I am less sanguine on this. However, what I have seen so far of it, and based on reports from people whose opinions I trust, it has significant promise.

MS is one of those things it seems to work for.

Kira, I just heard about LDN recently. (A friend's fellow water-class-goer was raving about how LDN has practically cured her Crohn's.) I googled it and found what little I discovered very interesting, particularly that it supposedly helps so many different autoimmune diseases and cancer with so few side effects. Having had Crohn's most of my life, I'm very skeptical when I hear these kinds of claims, but I also know some people have had miracle remissions or cures. I put LDN on my list of things to look into, but that's as far as I've gotten.

I'm interested in hearing more, should you have the time and propensity as your research progresses.

On the Valium subject, I try to minimize what I take that aggravates other conditions/illnesses. That said, I've taken and continue to take several meds that have less than thrilling side effects and health risks, because I would end up gravely ill or worse if I didn't. We have to weigh the pros and cons and make the best decisions we can at the time. (Only time will tell if those decisions were the "right" ones!)

twokatmew wrote: We have to weigh the pros and cons and make the best decisions we can at the time.

Right.

While it is a fact that benzodiazepenes can worsen sleep apnea, I don't know that a small dose is going to poison you. If your quality of life is down the tubes, I'd talk more to your doctor about it and possibly consider a trial with them. Apparently, you have the machine - and the ability to interpret that machine's data - to make it clear if the diazepam significantly worsens your apnea.

I have taken a very small dose of a benzodiazepam since 1981and still do. I take it in the morning. I was diagnosed with sleep apnea in 2002. I have software and the reader for my apap machine. My AHI is almost always below 1.

I also take a number of meds for Rheumatoid Arthritis which I have had since 1991.

That's my experience. Everyone is different.

I appreciate the feedback. I feel certain I'll need to add back the diazepam, and will work with the sleep doc to figure out the best way to do that while continuing to benefit from cpap. I feel like I know fibromyalgia inside & out because I've been dealing with it for so many years. OSA is still so new to me. It's taken a lot of energy to figure out the machine, mask, settings, etc. Now that all of that has fallen into place, it's time to re-address the "no sedatives" mandate from the sleep doc.

Thanks again for all your thoughts. I was offline for a day, but have made myself some notes from the different suggestions/comments I received. Will be doing a little bit of research between now and my next appt.
-K

Spirit wrote:Hi Kim,
My sleep doctor tells me, providing sedatives to patients, is like giving them poison if they have apnea. He explained in great details why & told me, I could find further information on the internet.

I honestly don't know, if I should post this here, but Klonopin contributed to worsening my apnea. Throat muscles were damaged (weakened), thyroid enlarged, and the list of damage goes on.

But there is good & bad side to every story. Many people have taken sedatives with positive results.

If you've experienced positive results, from meds/apnea treatments. I would follow the instructions of your physician, whom can provide the best advise & treatment, concerning your health issues.

Spirit

I'm curious about your comment on Klonopin damaging your throat muscles. Did your doctor tell you that? Is it a known side effect? I'm curious because I was on Klonopin for a while (maybe a little more than a year) up to 6 months before I started having serious EDS problems. It was another year before the OSA diagnosis.


Kim

I'm glad you got sensible advice here. One of the first things asked after an overnight titration is did you experience any pain during the night as that certainly affects the sleep quality.

I have friends who read every possible side effect of newly prescribed meds and then scare themselves into not taking them. One friend then doesn't tell her doctor she didn't take the med and he wonders why she isn't better and then prescribes something else, probably stronger. I have had people tell me that taking prednisone will "kill" me (I take a very small dose on alternate days). Not taking it will kill me much sooner. Quality of life is very important.

always_tired wrote: I'm curious about your comment on Klonopin damaging your throat muscles. Did your doctor tell you that? Is it a known side effect? I'm curious because I was on Klonopin for a while (maybe a little more than a year) up to 6 months before I started having serious EDS problems. It was another year before the OSA diagnosis.

Hi,
I am very cautious about the information, I share at forums, because each individuals experience is different, what has happened to me, does not mean it will happen to another. I am not here to frighten anyone, or discourage them, from treatments that are beneficial to them. I was just one of the unlucky ones.

Yes, Klonopin damaged my throat. It was confirmed by my sleep doctor, I was in perfect health, until Klonopin use, 3 years ago, all my nightmares began. I have an enlarged thyroid, and other throat issues.

For further information, contact me pm, and I will do my best to answer your questions. I will also send you documentation from my medical records.