Post
by Falcon1 » Wed Dec 03, 2008 8:55 pm
Rooster, Thanks for your comments and thanks for pointing out the potential side-effect of insomnia for some patients who try Allegra-D. I agree; that is a one of the potential side-effects of that medication (although I haven't experience it personally, with my usage of Allegra-D). Much appreciated.
I've been free from all of my sleep-disordered breathing related symptoms for two years now…and the contrast is STARKLY noticeable, after nearly 20 years of terrible suffering (with tremendous daytime drowsiness & chronic fatigue, mild snoring, and difficulty with arising out of bed in the mornings).
My main goal is to get the word out to others who may possibly benefit from what I've discovered. Certainly, what worked for me won't work for everybody; but I feel that it's important that others are aware of what I've discovered, just in case there may be some application in their particular case.
After I stumbled upon my incredible symptomatic relief from taking a Claritin tablet at bedtime, I later experimented with trying the two other 'non-sedating antihistamines' that are available besides Claritin, to see if they also would provide a similar degree of relief. I told my personal physician about my discovery, and worked in conjunction with him as I tried the other two meds - Zyrtec and Allegra.
In my experience as a doctor, when I'm treating patients for allergic rhinitis, often times many of them respond differently among the three medications in the non-sedating antihistamine class (Claritin, Zyrtec, and Allegra). So, if one doesn't work well (or causes side effects), then I have them try one of the others.
Before I started telling my own patients suffering from UARS, snoring, and mild obstructive sleep apnea about my personal discovery with Claritin, I wanted to see if I could experience the same beneficial effects with Zyrtec and Allegra, as well.
Through experimentation (in conjunction with my doctor), I found that taking Zyrtec (at bedtime) helped relieve my sleep-disordered breathing symptoms to a lesser extent than Claritin did, and Allegra didn't really help my sleep-disordered breathing symptoms at all.
I then got a prescription for Allegra-D (which is Allegra, plus the decongestant 'pseudoephedrine', as you mentioned) from my doctor, and I found that it worked incredibly well at relieving my sleep-disordered breathing symptoms, by taking it at bedtime. I now alternate periodically between Claritin at bedtime and Allegra-D at bedtime.
I have not experienced insomnia with the use of Allegra-D, nor have I had any patients who have had this as a side-effect. However, as you've mentioned, this can be a side-effect for some people who use anything with pseudoephedrine in it. Thanks for pointing this out, so that readers are aware of this.
The three non-sedating antihistamines (Claritin, Zyrtec, and Allegra) are considered generally safe, although no medication is without potential side-effects, of course. (And as you've also mentioned, Zyrtec can have a mild sedating effect, for some people.) Additionally, Allegra-D is a combination medication, and so it has the potential side effects of two different medications (fexofenadine and pseudoephedrine).
Claritin and Zyrtec are now available over-the-counter without a prescription, however Allegra and Allegra-D require a prescription.
Everyone should consult their licensed health-care providers before they use any medications...even over-the-counter ones, I believe, if it is their first time of usage.
When I am treating patients in my clinic for daytime allergic rhinitis symptoms, I've found that I often have to experiment among the three non-sedating antihistamines to find the right one, if they come to me for the first time with no prior experience with these medications.
Similarly, in regards to attempting to see if a non-sedating antihistamine can help with a person's sleep-disordered breathing symptoms, I find that it sometimes is necessary to experiment among the three non-sedating antihistamines (or Allegra-D), to find the one that works the best (since there's variation among results, in different people).
I felt I needed to include Allegra-D in my first post I wrote, since I found such dramatic relief with that particular medication at bedtime. But again, results vary and side effects vary among different individuals.
One last thing I'd like to add - I never suspected ever in my life that I had allergic rhinitis or allergies of ANY sort. I never have had any noticeable daytime runny nose, itchy watery eyes, sneezing, stuffiness, or any other such symptom. (I guess I'm lucky, because I know that there are many people out there who do suffer from such symptoms, chronically.)
It was only really because of the objective findings of the ENT doctor I visited for my sleep-related symptoms, who performed a nasoscope on me and found my mild nasal inflammation, that I had any thought at all of ever using a medication for it.
Additionally, I've since researched and found that it is actually common for many people, even those who have no daytime allergy symptoms or chronic rhinitis, to have some degree of swelling of their nasal passages at night after they have laid down to go to sleep. It appears to be related to lying horizontally..with the blood in our bodies being allowed to pool somewhat in our head and neck, since it's not being pulled downwards by gravity towards our feet anymore, like it is when we're standing or sitting. This then allows the capillaries in the mucous membranes to engorge slightly.
If there is already some degree of nasal passageway inflammation present (which I have found is also a somewhat common thing among patients, even non-symptomatic ones), then when this combines with the swelling of the nasal passageways at night upon reclining, it can result in a complete closing down of the nasal airway.
Our bodies seem designed to breathe most efficiently through our noses at night while we’re asleep. If our nasal passages are obstructed during the night, then we become forced to breathe through our mouth all night. When this happens, the soft tissues in the back of the throat typically begin to flop around and vibrate (which I found occurs even after having most of mine removed by palate surgery). This results in what is known as “snoring.” When snoring occurs (even if it's very mild or minimal snoring), we can disrupt the normal nighttime “sleep architecture,” which is crucial in order to wake up the next day feeling refreshed and well rested.
If we take steps to ensure that our nasal passageways have reduced obstruction during the night (as I found with my Claritin usage), then we're able to breathe through our nose while asleep, and (in my experience) avoid the problems which occur with mouth-breathing and snoring at night.
Obviously, if 'tongue obstruction' is causing airway blockage, as is typically the case with moderate and severe obstructive sleep apnea (and sometimes even mild OSA), then, of course, different measures are necessary to address that specific problem, i.e., CPAP, MMA, etc. However, even when patients are on CPAP for their OSA, I have found that many also benefit by taking something at bedtime to improve their ability to breathe through their noses while asleep.
Well, thanks again, Rooster, for the opportunity for me to make the above clarifications and distinctions. I appreciate what you've pointed out.
Best regards.
PS: Bottom line, please everyone check with and discuss this with your physicians or other licensed health care practitioners, if you think you might want to try any of the things that I have found have helped me.
