People with sleep apnea who take sleeping pills may face an increased risk of fatal consequences.
In Taiwan, one in every ten people suffers from chronic insomnia, leading them to use sleeping pills for relief. However, doctors caution that individuals with sleep apnea should be careful about self-administering sleep aids, as it may exacerbate respiratory suppression and increase the risk of fatal consequences.
The Relaxing Effect of Medication Aggravates the Condition
Dr. Lai Te-jen, Chairman of the Taiwan Society of Psychiatry and Chief of the Department of Psychiatry at Chung Shan Medical University Hospital, emphasized that identifying the cause of insomnia is crucial for effective treatment. Insomnia lasting for more than a month, where individuals still feel unrested upon waking up in the morning, can result from various factors such as sleep apnea, pulmonary diseases, gastroesophageal reflux, or emotional disorders. Addressing the root cause through fundamental therapies is essential, and relying solely on sleeping pills is not a sustainable solution.
Dr. Tsao Chang-yao, Vice President of Chung Shan Medical University and a pulmonary specialist, pointed out that excessive use of sleeping pills may paradoxically hinder sleep improvement. He shared a case of a 52-year-old woman with stubborn insomnia who took six types of sleeping pills without significant improvement. Sleep monitoring revealed that her deep sleep phase accounted for 70% of total sleep time, with only 15% in rapid eye movement (REM) sleep. Her sympathetic and parasympathetic nervous system ratio was too low, indicating an overdose of medication leading to drowsiness rather than normal sleep. After reducing the dosage of sleeping pills, she was diagnosed with mild depression, and with additional therapeutic approaches, her sleep problems were genuinely improved.
Dr. Tsao further highlighted a case of a truck driver suffering from insomnia for 5 to 6 years despite taking sleeping pills. A recent medical examination revealed severe sleep apnea due to obesity. With the use of positive airway pressure therapy during sleep and a weight loss plan, significant improvement was observed.
However, Dr. Lai Te-jen reminded individuals seeking to improve sleep to engage in daytime activities, avoid excessive bed rest, minimize consumption of stimulants like coffee and tea, address emotional issues, and practice relaxation techniques such as yoga or meditation before bedtime. Instead of relying solely on medication, seeking proper medical advice and following prescribed sleeping pill regimens is crucial.
Pharmacist Li Chun-da from the Pharmacy Department at Taipei City Hospital Songde Branch reminded the public that sedative-hypnotic medications primarily function to relieve tension, anxiety, aid in sleep initiation, induce muscle relaxation, and alleviate spasms. Different sedative-hypnotics vary in strength and effectiveness for different individuals. Dosages are adjusted by physicians based on patient conditions, and discontinuation of medication should be discussed with a doctor using a gradual tapering approach. Abrupt cessation may lead to symptoms such as anxiety, seizures, or rebound insomnia.
He also cautioned against self-adjusting medication dosage, either increasing it due to perceived inadequate effects or reducing it out of concerns about side effects. Inappropriate and prolonged use of sedative-hypnotics can lead to physiological dependence, potentially causing issues like memory impairment and decreased reaction times.
