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Research Questions Use of Sleep Meds for Patients with Apnea

Prescription sleep aids may do little to improve the use of continuous positive airway pressure// (CPAP) among patients with obstructive sleep apnea (OSA). A new study published in the November issue of CHEST, the peer-reviewed journal of the American College of Chest Physicians (ACCP), finds that patients with OSA who were given prescription sleep aids were no more likely to use their CPAP machines than patients with OSA taking a placebo.

“CPAP treatment improves daytime alertness and quality of life for most patients with OSA and may prevent some of the long-term complications of this disorder, including heart attacks and strokes,” said the study's lead author Capt. David A. Bradshaw, MD, FCCP, Naval Medical Center, San Diego, CA. “Yet, many people find CPAP difficult to use. People with a good initial experience are more likely to use CPAP regularly. Our hypothesis was that a sleeping pill might help new CPAP users adjust to sleeping with the equipment and promote long-term usage.”

To determine the effect prescription sleep medications have on CPAP compliance, Capt. Bradshaw and colleagues compared CPAP use among 72 newly diagnosed male patients (mean age 38 ± 7 years) who were referred for CPAP treatment. All patients participated in standardized CPAP training and were randomized to receive the sleeping agent zolpidem (N=24), a placebo pill (N=24), or standard care (N=24) with no sleeping pill or placebo. Patients taking zolpidem or placebo were instructed to take one pill each night, 30 minutes prior to bedtime for the first 14 days of treatment. During the four-week trial, CPAP use was recorded by an internal data chip.

Compared with the placebo pill and standard care groups, the zolpidem group did not show greater CPAP usage in terms of total days used or average time used per night over the course of four weeks. When the initial 14 days of CPAP treatment were analyzed separately, there was also no difference in number of d
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