Associations between the use of common medications and sleep architecture in patients with untreated obstructive sleep apnea

STUDY OBJECTIVES: Obstructive sleep apnea (OSA) is often associated with other disorders, which are usually treated with medications. Little is known about the extent to which medications are used in the OSA population or the effects of common prescription medications on the sleep architecture of patients with OSA. The aim of this study was to describe the frequency of use of medications by patients with untreated OSA and to examine the potential associations between specific, frequently used medication types and indexes of sleep architecture assessed through laboratory-based polysomnography. DESIGN: This study used a retrospective design with analyses of archival clinical data. SETTING: Tertiary public sleep disorders center in Brisbane, Australia. Patients or Participants: Consecutive patients with a clinical diagnosis of OSA (N = 1779). INTERVENTIONS: None. MEASUREMENTS AND RESULTS: Of the patients with OSA, 77.1% were taking at least 1 medication; 12.4% were taking beta-adrenergic receptor-blocking agents and 20.8% were taking antidepressant or anxiolytic medications. Analyses of covariance demonstrated reliable effects of medication use on sleep architecture, after accounting for age, sex, and body mass index variables. Both tricyclic and selective serotonin reuptake inhibitor antidepressant or anxiolytic medications were associated with a lower percentage of rapid eye movement sleep and lower sleep-efficiency values in patients with OSA, compared with those not taking any medications. The use of beta-adrenergic receptor-blocking agents and aspirin had no consistent associations with the indexes of sleep architecture. CONCLUSIONS: Medication use was high within this sample of patients with OSA. Some common medications may be associated with differences in objective sleep quality in a large proportion of patients with OSA. The potential effects of classes of common medication on both the presentation and treatment of OSA need to be further assessed