Recent research indicates that a common antipsychotic medication may help alleviate obstructive sleep apnea (OSA), though it raises concerns about impaired driving. This conclusion comes from a small randomized controlled trial published in the Annals of the American Thoracic Society.
Conducted by researchers at Flinders University in Adelaide, Australia, the study involved 15 adults with OSA who also faced challenges in maintaining sleep. Each participant engaged in two overnight sleep studies approximately a week apart.
One night, participants took 50mg of quetiapine, an antipsychotic prescribed for conditions like schizophrenia, bipolar disorder, and depression. The following night, they received a placebo.
The study observed significant changes in sleep patterns. Those who took quetiapine experienced over 40 minutes more sleep time and a 45% reduction in nighttime wakefulness. Apnea-related events decreased from 27 to 20 per hour. Despite these improvements, quetiapine slowed driving reaction times, based on a driving simulator and a 10-minute reaction time test conducted shortly after waking.
“Participants taking quetiapine showed over three times the attention lapses and more frequent lane swerving in simulator tests.”
Eleven of the 15 participants reported increased sleepiness the morning after taking quetiapine, with one in four failing to recognize their reduced alertness. This poses safety concerns, as individuals might drive or operate machinery without realizing their impaired reaction times.
Other noted side effects included nausea, restless legs, and a sudden drop in blood pressure upon standing, affecting about one third of quetiapine users.
The study had limitations, including a small sample size and a single night evaluation in a lab setting. Longer, more comprehensive studies are necessary to confirm these findings before advising on quetiapine use for sleep apnea and insomnia.
Pending further research, experts recommend avoiding driving or safety-sensitive tasks for at least 9.5 hours after quetiapine intake. Sex differences in drug metabolism mean women metabolize these drugs slower, which could affect efficacy and side-effect risk. Ashley Curtis, PhD, emphasizes examining sex-specific patterns for safe dosing recommendations.
The effect of quetiapine on cognitive function the following day requires more study, especially among older adults who may already be vulnerable to cognitive side effects due to multiple medications. Behavioral interventions like cognitive behavioral therapy remain valuable for long-term insomnia management.
Chelsie Rohrscheib, head sleep expert at Wesper, recommends patients consult their doctor to weigh the benefits and risks of quetiapine for sleep issues, especially if experiencing factors like sleep apnea or morning grogginess.