Can Sedatives Affect Sleep Test Results for Sleep Apnea?

Sleep study

Hello doctor, I would like to ask a question.
I usually experience a lot of work-related stress and have been seeing a psychiatrist who prescribed me alprazolam (Xanax) to take three times a day.
However, I only take it before bed and have been doing so for several years.
I also have severe snoring issues, so I underwent a sleep study at a hospital in New Taipei City.
The hospital's sleep study instructions only mentioned not to take sleeping pills, but did not specify that I shouldn't take sedatives.
Out of fear of not being able to sleep, I took half a dose of the sedative during the test.
Later, the results showed that I had severe obstructive sleep apnea.
I chose to undergo surgery for treatment, but since then, I have been enduring some painful and uncomfortable side effects.
Later, someone told me that sedatives should not be taken during a sleep study, and I began to wonder if I might not have had obstructive sleep apnea at all, but rather it was caused by the sedative.
I asked my attending physician about this, but he said that taking the sedative would not affect the test results.
Therefore, I would like to ask you, can taking this sedative during a sleep study cause obstructive sleep apnea?

Louis, 40~49 year old female. Ask Date: 2022/06/30

Dr. Li Jiaxuan reply Otolaryngology

Sedatives can cause muscle relaxation.
If you do not usually take them, it is best not to take sedatives just for the purpose of undergoing an examination.
Individuals who experience severe sleep apnea should refrain from taking medication, as they may still have sleep apnea without it.
It is recommended to measure again without medication.
Wishing you safety.

Reply Date: 2022/06/30

More Info

The use of sedatives, such as alprazolam, can indeed affect the results of sleep tests, particularly those assessing for sleep apnea. Sedatives are known to have a muscle-relaxing effect, which can lead to increased airway obstruction during sleep. This is particularly relevant for individuals who already have a predisposition to sleep-disordered breathing, such as obstructive sleep apnea (OSA).
In your case, taking alprazolam before the sleep study may have contributed to the severity of the apnea observed during the test. While your doctor mentioned that the sedative would not affect the results, it is important to note that the effects of sedatives on sleep architecture and respiratory function can vary from person to person. Sedatives can alter the normal sleep stages, particularly reducing REM sleep, which is crucial for restorative sleep. They can also lead to a decrease in muscle tone in the upper airway, increasing the likelihood of airway collapse and subsequent apneas.

Given that you have a history of severe snoring and were diagnosed with significant sleep apnea, it is plausible that the sedative could have exacerbated the condition during the test. However, it is also important to consider that if you have underlying sleep apnea, it may still be present regardless of the sedative use. The best course of action would be to discuss your concerns with your healthcare provider and consider a follow-up sleep study without the use of sedatives to obtain a clearer picture of your sleep apnea severity.

In terms of treatment, if you are experiencing significant side effects from surgery or ongoing symptoms of sleep apnea, it is crucial to communicate these issues with your healthcare provider. They may recommend alternative treatments, such as continuous positive airway pressure (CPAP) therapy, which is often the first line of treatment for OSA. Additionally, lifestyle modifications, such as weight loss, positional therapy, and avoiding alcohol and sedatives before bedtime, can also help manage symptoms.

If you are still experiencing symptoms of excessive daytime sleepiness, fatigue, or cognitive impairment, it is essential to address these with your doctor. They may suggest further evaluations or adjustments to your treatment plan to ensure that you are receiving the most effective care for your condition.

In summary, while sedatives like alprazolam can potentially influence the results of a sleep study for sleep apnea, it is essential to consider the broader context of your health and symptoms. A thorough discussion with your healthcare provider can help clarify the best path forward for managing your sleep apnea and any related concerns.

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