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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 7 of 7. This is the beginning of the thread.
Posted by Rick on September 11, 1999, at 5:25:10
I was diagnosed with Severe Obstructive Sleep Apnea about one and one-half years ago. I just can't tolerate CPAP, and don't use the machine I have. I believe the apnea MAY have subsided to a large degree since I've 40 pounds, but this is based soley on my spouse's occasional observations. I am mildly hypertensive (don't know whether it's apnea related or not), and my p-doc prescribed very low-dose Pindolol, a non-selective beta blocker with supposed seratonergenic (sp?) effect.
My question: Now, about 6 weeks after starting 2mg average daily Klonopin for Social Phobia -- with very promising results -- I have read that long-acting benzos like Klonopin can aggravate apnea (and other resperatory ailments).
Has anyone out there dealt with a similar scenario? Does anyone have any advice/cautions/re-assurances? Given Klonopin's long-acting profile, is there any benefit to taking all of the day's dose before 6 p.m.? And could the Pindolol be making things worse yet (I've read that non-selective beta blockers disturb sleep)?
I'm not taking an AD, and I'd really prefer not to (after trying Nardil and various potentiators, with a net result of erratic effectiveness, major side-effects, and total poop-out after eight weeks). I have no other psych disorders that I know of, except perhaps mild OCD. The Klonopin's working so well, I'd hate to give it up. Any thoughts?
Thanks,
Rick
Posted by Noa on September 11, 1999, at 9:36:02
In reply to Klonopin and Obstructive Sleep Apnea, posted by Rick on September 11, 1999, at 5:25:10
I also have OSA, but have no experience with Klonopin. Have you visited sleepnet.com? There is a great forum there for people with OSA.
Posted by Bob on September 11, 1999, at 15:59:25
In reply to Klonopin and Obstructive Sleep Apnea, posted by Rick on September 11, 1999, at 5:25:10
Klonopin's been a dream for me -- I can't imagine how I was ever able to function without it, given that if I forget it in the AM, by noon I'm a cognitive and emotional wreck. Thank goodness it works so fast for me -- I can pop my emergency back-up in my briefcase and be settled in 20 mins. or so.
You don't say how much you're taking -- I'm only on 1mg/day. But taking with my AD after breakfast works great for me. No apnea at all (and after being on perphenazine, I *know* just how nasty *that* can be!!).
So, you might want to try taking it in the AM, or splitting your dose if you can. Have you checked on this with your pdoc?
Cheers,
Bob
Posted by Noa on September 11, 1999, at 18:11:08
In reply to Klonopin and Obstructive Sleep Apnea, posted by Rick on September 11, 1999, at 5:25:10
I was also thinking some more about your post, Rick. What makes your cpap intolerable? A lot of people have had problems that are fixed well with minor adjustments in the equipment, like the type of mask you use, or whether you are using a heated humidifier attachment (that made ALL the difference in the world for me). Certainly with the weight loss, you might need a lower air pressure.
Posted by Rick on September 11, 1999, at 19:44:02
In reply to Klonopin and Obstructive Sleep Apnea, posted by Rick on September 11, 1999, at 5:25:10
Bob and Noa -- Thanks for your thoughts.
Bob - I take 1.5-3.0 mg/day, depending on the particular stresses I will be facing (presentations, parties, tough meetings). Ususal is 2.0-2.5. Are you taking the Klonopin for Social Phobia or some other anxiety/disorder? What AD are you using?
Noa - I appreciate your interest in my CPAP intolerance. I will definitely check out the site you recomended, although I have seen sleep disorder sites in the past. Maybe I just need a little more self-motivation and need to experiment more and look into alternate equipment (sigh..).
I could write a book on why I hate my "deluxe" CPAP, but I'll point out a few highlights: For one thing, during the sleep lab test I felt like I was hardly sleeping at all. But during the middle of the night, they came in and said "you've had the number of episodes that require we put you on CPAP immmediately", and they did. It was awful. When it was time to leave, they said my apnea episodes dropped markedly with the machine and that I know doubt felt "great". To the contrary, I walked out feeling like a zombie -- worst morning in a month.
I can't stand sleeping with my mouth closed -- it feels SO un-natural. And I hate the chin-strap that holds my mouth shut. Without the chin-strap, my mouth invariably leaks air with those weird "sucky" sensations. And even when I AM able to tolerate mouth--closed sleeping, I fidget because I don't the "right" way to do it: should I clamp my teeth (which encourages unhealthy grinding); try to hold them apart with my tongue held back; or put my tongue between my teeth, etc.
I've often had facial pain (TMJ?), and the CPAP with it's "truss" around my face tended to make this feel worse. (Of course, since I've been on psych drugs -- all since quittng CPAP -- the facial pain seems to have largely dsappeared for some reason, so maybe this would no longer be as great a factor re the CPAP). Also, irritations like red marks across my forehead; chin strap coming off (velcro pulls apart...and I'm not sure how to position it, anyways); and a sensation of leaks around my nose despite tightening. Gawd, I wish there wasa med or effective surgery for this!
> I was diagnosed with Severe Obstructive Sleep Apnea about one and one-half years ago. I just can't tolerate CPAP, and don't use the machine I have. I believe the apnea MAY have subsided to a large degree since I've 40 pounds, but this is based soley on my spouse's occasional observations. I am mildly hypertensive (don't know whether it's apnea related or not), and my p-doc prescribed very low-dose Pindolol, a non-selective beta blocker with supposed seratonergenic (sp?) effect.
>
> My question: Now, about 6 weeks after starting 2mg average daily Klonopin for Social Phobia -- with very promising results -- I have read that long-acting benzos like Klonopin can aggravate apnea (and other resperatory ailments).
>
> Has anyone out there dealt with a similar scenario? Does anyone have any advice/cautions/re-assurances? Given Klonopin's long-acting profile, is there any benefit to taking all of the day's dose before 6 p.m.? And could the Pindolol be making things worse yet (I've read that non-selective beta blockers disturb sleep)?
>
> I'm not taking an AD, and I'd really prefer not to (after trying Nardil and various potentiators, with a net result of erratic effectiveness, major side-effects, and total poop-out after eight weeks). I have no other psych disorders that I know of, except perhaps mild OCD. The Klonopin's working so well, I'd hate to give it up. Any thoughts?
>
> Thanks,
> Rick
Posted by Noa on September 11, 1999, at 20:36:00
In reply to Re: Klonopin and Obstructive Sleep Apnea, posted by Rick on September 11, 1999, at 19:44:02
rick,
It might help you to talk to some of the folks at the sleep forum, about the ins and outs of the equipment. Also, if you have lost weight and your apnea is less frequent or less severe, you might now be a candidate for laser surgery or something like that.
Posted by Bob on September 11, 1999, at 22:39:11
In reply to Re: Klonopin and Obstructive Sleep Apnea, posted by Rick on September 11, 1999, at 19:44:02
> Bob - I take 1.5-3.0 mg/day, depending on the particular stresses I will be facing (presentations, parties, tough meetings). Ususal is 2.0-2.5. Are you taking the Klonopin for Social Phobia or some other anxiety/disorder? What AD are you using?
I'm taking it for panic disorder. I wasn't getting medicated for it, since I first went to my pdoc for help with my ADs, and we kind of stumbled across prescribing it for me. All I know is that my life has been subtly but profoundly better ever since. As for the ADs I've been on while taking klonopin:
(1) prozac
(2) prozac + lithium (potentiator)
(3) zoloft + lithium (p)
(4) zoloft + nortriptyline (p)As you might guess, I've been having quite some time trying to settle on a cocktail that gives me any solid sense of well-being ... but the klonopin has been rock-steady for me through all those combos.
Cheers,
Bob
This is the end of the thread.
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