Comment

Comment by Mike on February 22, 2009 at 5:48pm

i've never heard of Remeron. any info you can provide would be appreciated. thanks.

Comment by Cuddleydoc on February 22, 2009 at 5:30pm

I am a physician who has sleep apnea. Without any treatment my AHI is 37. Using a dental appliance brings my AHI to 15. If I add Remeron in addition to using the dental appliance my AHI drops to 8. If I use the dental appliance and Remeron AND sleep only on my side my AHI drops to 5. Remeron definitely benefits my sleep apnea but it is not enough to bring me to normal (AHI equal to 5 for less) by itself. Remeron alone drops my AHI to 15.

Comment by Randy Bray on February 22, 2009 at 2:52am

It's an interesting idea, but I don't think I would try it if I still had sleep apnea. I think we're going to see an increase in the type of surgery I had a UPPP AND a Lingual Tonsillectomy, the dual procedure fixed mine by at least 95% I would rather go through the surgery and a couple of weeks of recovery then to take a med that tinkers with my brain chemistry.

Comment by Steven Y. Park, MD on February 21, 2009 at 10:21pm

Don't hold you breath. There have been many pills for sleep apnea that have come and gone. One recent one was mirtazapine, which is a norepinephrine and serotonin agonist, which actually dropped the AHI in one study by 50%. As far as I know, they're doing further clinical trials. One possible mechanism is that these medications suppress REM sleep. Since apneas can occur more often in stage REM (due to total muscle relaxation), by shifting your REM sleep to delta stage sleep (formerly called 3&4), you're less likely to obstruct.

The problem with this approach is that you're just covering up the problem, without addressing the cause. Obstructive sleep apnea is an upper airway anatomic problem. It's due to a combination of our ability to talk and our modern day diets and other habits (one such proposed mechanism is bottle-feeding). It's a physical problem that manifests in physiologic, biochemical, hormonal, and neurologic changes. For now, the only ways to treat it is by physical means: lose weight (for those that are overweight), CPAP, dental devices and surgery.

Comment by Banyon on February 21, 2009 at 9:45pm

Being suspicious of pharmaceuticals because of their side effects, I pray for the trials on implantable devices to electrically stimulate the airway muscles to proceed unusually rapidly and unusually successful.

Comment by sleepycarol on February 21, 2009 at 9:42pm

Wonder what side effects the drug has?

It seems for every "miracle" drug there are a number of side effects that can range from mild to life threatening.

Also -- wonder what the costs would run?

I wish them luck as it might just be the thing for many that are now noncompliant if it is deemed safe.

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