Sleep apnea is a mild disorder only in appearance: in fact, the risk of complications increases excessively when the episodes of nocturnal apnea become frequent and the time to stop breathing is rather long. Among the most alarming complications, cardiovascular disorders such as hypertension , stroke , atrial fibrillation and congestive heart failure stand out. Not to mention the risks involved in the patient suffering from sleep apnea after surgery, being more susceptible to respiratory problems; even the administration of some drugs can weigh on sleep apnea.
The main goal of night apnea therapy is to improve sleep qualityof the patient who is affected, thus avoiding all the consequences that could result. Once again, the specific treatment must be personalized to the individual patient, depending on the severity of the symptoms and the triggering cause; for example, hypertrophy of tonsils and adenoids in children can cause sleep apnea; in general, their surgical excision determines complete recovery from nocturnal disturbance. In some affected patients, the use of an oxygen mask is recommended, which creates a positive pressure inside the airways: it is a mini respirator (or ventilator) useful for keeping the airways between the muscles released. Others require specific dental prostheses to propel the jaw forward, especially the patients subjected to the relaxation of the neck muscles during the nighttime rest: the application of the prosthesis is indicated not only for the prevention of sleep apnea, but also to improve nighttime breathing in some affected or at risk subjects.
Since nocturnal apneas are recurrent phenomena in obese people , it is recommended, in this case, to follow a hypocaloric diet to reduce body weight (see: article on drugs for the treatment of obesity ); among other general rules, it is also recommended not to drink alcohol for 4-6 hours before going to sleep, do not take sedative drugs and stop smoking .
Let’s see, now, what drugs are used in therapy to alleviate the symptoms of nocturnal apnea.
The following are the classes of drugs most used in therapy against nocturnal apnea, and some examples of pharmacological specialties; it is up to the doctor to choose the active ingredient and dosage most suitable for the patient, based on the severity of the disease, the health status of the patient and his response to treatment:
First-line drugs for night sleep apnea
Most of the patients suffering from sleep apnea complains of an unpleasant feeling of having slept badly, with repercussions during the day: the subject, in fact, tends to suffer from drowsiness. When daytime lethargy becomes important, it is sometimes advisable to administer stimulant drugs , such as amphetamine or anti-narcotics.
- Theophylline (eg Aminomal Elixir, Diffumal, Respicur) just like caffeine, theophylline is a xanthine drug used in therapy (and not only) for the treatment of sleep apnea, useful both to reduce the frequency of episodes, and to lighten them. satellite symptoms, such as insomnia . Theophylline is also indicated for the treatment of nocturnal apnea of the newborn. As an alternative to theophylline, the infant can be cured with the oral administration of cafein citrate ( nymusa ) at a dose of 10-20 mg / kg (maintenance dose: 5 mg / kg). Discontinue the treatment with theophylline or caffeine after 7 days from the disappearance of symptoms.
- Modafinil (eg Provigil ): the drug is a stimulant, indicated for the treatment of sleep disorders such as hypersomnia and narcolepsy in the context of sleep apnea; the active ingredient works by promoting the release of neurotransmitters (monoamine), and raising the levels of histaminehypothalamus. The drug should be taken at a dose ranging from 150 to 250 mg, once a day, preferably in the morning. The dose varies according to the severity of the disorder: it is minimal in the case of slight hypersomnia and is higher when the disorder degenerates into narcolepsy in all respects (if the sleep apnea is a serious problem). However, the effective dose, even for mild forms of somnolence, should not fall below 150 mg.
- Amphetamine and Destroamfetamine (eg DextroStat, Adderall, Dexedrine): belong to the class of sympathomimetic amines , substances stimulating the central nervous system . It is recommended to start therapy with a dose of 10 mg, to be taken orally , in the morning. If necessary, it is possible to correct the dosage for the maintenance phase, increasing 10 mg every 7 days (not exceeding 60 mg per day), in addition to always fractioning the dosages. This dose is generally considered for the treatment of narcolepsy. Lower doses are indicated to treat moderate and moderate hypersomnia in the context of sleep apnea. The drug is also available as capsulesslow-release and oral solution. Consult your doctor.