By Joke Kujenya
EVIDENCE FROM a new study has highlighted potential next day attention and driving risks associated with a commonly prescribed sleep aid in people with obstructive sleep apnoea.
JKNewsMedia.com reports that researchers at Flinders University in Australia examined the effects of quetiapine, sold as Seroquel, in a small clinical trial involving people with obstructive sleep apnoea and difficulties staying asleep.
Quetiapine is an antipsychotic drug approved for conditions including schizophrenia and bipolar disorder. Studies have shown it can improve sleep quality, and it is often prescribed at lower doses as an off-label treatment for insomnia.
“There’s a growing belief that low dose quetiapine is a relatively harmless way to help people sleep,” said first author and sleep scientist, Cricket Fauska.
“Our results show it’s not that simple.”
The study also assessed 15 people with obstructive sleep apnoea and problems staying asleep.
Researchers found that while quetiapine improved sleep to some extent, participants experienced poorer performance the next day.
“Although participants slept longer and woke less overnight, their reaction times were slower, and their simulated driving performance was noticeably worse the next morning.”
On a 10-minute psychomotor vigilance test, participants reacted more slowly after taking quetiapine than after taking a placebo. Attention lapses during the test increased from a median of two after placebo to 10 after quetiapine.
During a driving simulation, participants drifted an average of 33 per cent farther from the centre of their lane after taking quetiapine compared with placebo.
The rate of actual crashes in the simulator almost doubled with quetiapine compared with placebo, although researchers noted that the small sample size limited the statistical effect.
“What was particularly concerning is that some people didn’t feel especially sleepy the next day, despite performing worse on objective tests,” Fauska said.
“That mismatch between how people feel and how they actually function poses a serious safety risk, especially when it comes to driving.”
Researchers said the study does not show that quetiapine is always unsafe and noted that doctors regularly prescribe medications off label when the benefits may outweigh the risks.
However, the team called for tighter regulation of quetiapine prescriptions.
Obstructive sleep apnoea and insomnia often occur together. Researchers noted that around 80 per cent of people with obstructive sleep apnoea are thought to be undiagnosed.
People with the condition may wake frequently or struggle to remain asleep, making symptoms difficult to distinguish from insomnia.
“Our findings suggest quetiapine should not be used as a routine sleep medication in people with known or possible sleep apnoea, particularly when next day alertness is critical,” said sleep scientist Danny Eckert of Flinders University.
JKNewsMedia.com also reports that researchers said future studies should examine quetiapine in larger groups, at different doses and over longer periods. The trial involved only one night of quetiapine and one night of placebo and could not determine the effects of repeated use.
“Sleep apnoea is a complex condition with different underlying drivers in different people,” Eckert said.
“What we’re learning is that treatment needs to be tailored, using the right approach, or combination of approaches, for the individual rather than defaulting to sedating medications.”
The findings were published in the Annals of the American Thoracic Society.
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