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Just came across this on my Linked-In Account.  Will Twitter it too!  Don't shoot the messenger LOL.  Just thought you all might like to see it:-
ps  Sorry about the big font - it's because I copied + pasted it!

Attempts to treat sleep apnea with a pill continue - and here is one more attempt
with one - actually two pills. Researchers from Chicago used 4 weeks of a
an interesting combination of combination of fluoxitene, a serotonin
reuptake inhibitor, and ondansetron (a 5HT3 antagonist) in 35 adults
with sleep apnea. Participants received either drug alone, only placebo
and the combination of both. A 40% reduction in AHI was seen at the end
of the study period. Interesting data -- may point to some potential
novel targets for the future.

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My sister was put on an antidepressant (reuptake inhibitor)..and she only took TWO pills.. One _ one day and another the next. I have had her at my house for 4 days now trying to help her recover from the side effects. She was unable to even talk the first day I got her here. I don't understand how ANYONE can take these drugs in the first place.. AND.. isn't REM state the MOST beneficial...deepest...most healing time of our sleep at night?? Why would anyone want to lessen that.??
I am quite certain that for a long time before my son died... He NEVER atttained REM sleep hastening all the events which led to his death.

IT would have to undergo a LOT of testing before I would ever consider taking anything like that. I , personally, would believe in going a NATURAL path before a chemical one any day.
Good point Dr. Park. That would be a "dirty trick" to lessen one's AHI. From my experience, most that suffer from sleep apnea tend to be worse and have many respiratory events concentrated in REM from the reason(s) you stated.

Steven Y. Park, MD said:
I'm not sure about these particular drugs, but many anti-depressants suppress REM sleep. So by lessening REM, you'll have less apneas, since that's when your throat muscles relax the most. Mirtazapine actually lowered the AHI by 50%.
I have been using Remeron successfully to treat my sleep apnea. When I was diagnosed with sleep apnea my AHI was 38.
With a dental appliance it is reduced to 15. When I use Remeron with the appliance my AHI drops to 6. The studies show that Remeron helps some people but not others, This suggests that there may be different subtypes of sleep apnea. For example people who have severe anatomical problems would not be helped by drugs but those who just have poor neurotransmission to throat muscles are helped by drugs which increase neurotransmission.
I think its important here to realize that Sleep Apnea can have several different causes. Its unlikely that one solution, such as a pill, would work in all cases. I suspect that Dr Park is on the right track that this combination of drugs is actually suppressing REM. Personally I wouldn't see that as a very good solution.

In my mind Sleep Apnea is more of a symptom than a disease. The trick then becomes figuring out why one has sleep apnea and targeting the correct area of obstruction or cause for collapse.
I have tried provigil, however it give me a strange spacy feeling so it's a no go for now. I think 5 hour energy is the SAFEST best for staying awake. CAFFEINE PILLS are probably the worst way to do it. I know, I have used them.

Frank
@Banyon

Do we have numbers for what seems to me to be the nub of the issue?

Is there a published authoritative study correlating OSA with weight/BMI?

I suppose in simple terms I am asking whether you are totally exceptional and outside the OSA mainstream; suffering from a different malady in fact.

If weight is the problem in the generality of OSA cases then pursuing drug treatments, surgical interventions, psychological/psychiatric regimes is all so much wasted energy and money.

I know doctors shy away from value judgments. "You are fat. Lose weight and your blood pressure, diabetes, snoring, daytime fatigue problems will all go away" sort of thing. But, really, is that the truth of it for 99% of OSA sufferers?

It seems a simple enough question and I can't believe there is no reliable data around. But where is it?
@Brian, I am 5' 3" 116 lbs. I have never weighed over 120 lbs. All 3 sleep docs mentioned to me that I do not fit the profile of a person with OSA. Yesterday I was speaking with one of my clients and I started yawning. My co-worker mentioned that I have Sleep Apnea (TMI, but oh well) my client said the same thing, "you are too little to have Sleep Apnea." She is a nurse ! Interesting don't you think ?
Donna B.

Brian Smith said:
@Banyon

Do we have numbers for what seems to me to be the nub of the issue?

Is there a published authoritative study correlating OSA with weight/BMI?

I suppose in simple terms I am asking whether you are totally exceptional and outside the OSA mainstream; suffering from a different malady in fact.

If weight is the problem in the generality of OSA cases then pursuing drug treatments, surgical interventions, psychological/psychiatric regimes is all so much wasted energy and money.

I know doctors shy away from value judgments. "You are fat. Lose weight and your blood pressure, diabetes, snoring, daytime fatigue problems will all go away" sort of thing. But, really, is that the truth of it for 99% of OSA sufferers?

It seems a simple enough question and I can't believe there is no reliable data around. But where is it?
Brian Smith said:
@Banyon

I can't believe there is no reliable data around. But where is it?

------------------------------------------------------------------------------------------------------------------------------------------------

THE MAJORITY OF OSA PATIENTS ARE NOT OBESE

1) http://jama.ama-assn.org/cgi/content-nw/full/283/14/1829/TABLEJOC91...

2) See also pretty little colored pie charts at http://www.sleepapnea.org/resources/pubs/bmi.html
Brian Smith said:
I know doctors shy away from value judgments. "You are fat. Lose weight and your blood pressure, diabetes, snoring, daytime fatigue problems will all go away" sort of thing. But, really, is that the truth of it for 99% of OSA sufferers?


You need to discard the old myth that obesity causes obstructive sleep apnea. It's narrow jaws that cause sleep apnea. See http://doctorstevenpark.com/sleeplossandbellyfat

There are many other resources on the internet concerning this.
Too true. I've just been sat here talking to my daughter (who's a nurse) about obesity only being a small part of OSA. Our theory is that perhaps obese people were the first kind to be diagnosed due to obesity causing other health problems. When I, myself, was diagnosed everyone kept asking if I was sure the test was correct, as I didn't 'look' like someone with OSA duh!
I believe obesity is a condition occurring at worst stages of sleep apnea. As I have previously posted on another page..my son, who died at age 22, had sleep apnea to some degree most all of his life. Six months before he died he weighed 220 pounds. When he died he weighed 427 pounds. The funeral home director told me that almost " ALL " sleep apnea deaths that he had seen had also been cases of morbid obesity. I have sleep apnea and I am small boned 5ft 5 in tall and only weigh about 128-130 pounds, depending on how many hershey kisses I have downed that day.... ANYONE can get sleep apnea..weight would not be an issue.
"The funeral home director told me that almost " ALL " sleep apnea deaths that he had seen had also been cases of morbid obesity."

That is because the medical profession doesn't suspect sleep apnea death in normal weight people and the cause of death gets labeled as stroke, heart attack, etc.

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