One treatment that I was using for about 6-8 months before I had my sleep study, but didn't realize that it had been proven to improve both central & obstructive sleep apnea, was the antidepressant mirtazapine. (I took 15 mg the night of my diagnostic sleep study, and I am still taking it each night.)
I started taking it to help insomnia of the delayed sleep onset type.
The NIH study that I've referenced below doesn't recommend mirtazapine for treatment of sleep apnea because of weight gain and sedation.
The study found that mirtazapine decreases AHI by around 50%. That's a big improvement, but it's not good enough unless a person only had mild sleep apnea to begin with.
I think it could be a good treatment for people with mild sleep apnea, but they might need some sort of help with avoiding weight gain, like a weight and nutrition accountability group.
I gained 16 pounds during the first six months that I took mirtazapine, and then my weight stabilized. I haven't found it to cause binge eating. It seems to cause sporadic increases in overall appetite and a craving for carbohydrates.
I also don't find it to be sedating during non-sleep time. I started off at a dosage of 3.75 mg, though, not 15 mg like some of the people in the study. I think some of the reported daytime sedation could be due to their starting at 15 mg.
From the study abstract: (I bolded and italicized sentences below that I thought were particularly important.)
Efficacy of mirtazapine in obstructive sleep apnea syndrome
Carley DW1, Olopade C, Ruigt GS, Radulovacki M.
Decreased serotonergic facilitation of upper-airway motor neurons during sleep has been postulated as an important mechanism rendering the upper airway vulnerable to obstruction in patients with obstructive sleep apnea syndrome (OSA).
Although serotonin reuptake inhibitors have been shown to produce modest reductions in the apnea-hypopnea index (AHI) during non-rapid eye movement (NREM) sleep, they have not been proven to be generally effective as treatments for OSA.
Conversely, antagonists of type 3 (5-HT3) serotonin receptors effectively have been shown to reduce the frequency of central apneas during rapid eye movement (REM) sleep in a rodent model of sleep-related breathing disorder.
We sought to determine whether mirtazapine, a mixed 5-HT2/5-HT3 antagonist that also promotes serotonin release in the brain would effectively reduce AHI during both NREM and REM sleep in patients with OSA.
A randomized, double-blind, placebo-controlled, 3-way crossover study of mirtazapine in patients with OSA.
Laboratory studies were conducted in the Center for Sleep and Ventilatory Disorders at the University of Illinois Medical Center.
Seven adult men and 5 adult women with newly diagnosed (treatment-naïve) and medically uncomplicated OSA were randomized into the study.
Each subject self-administered oral medications 30 minutes before bedtime each night for 3 consecutive 7-day treatment periods. These treatments comprised (1) placebo, (2) 4.5 mg per day of mirtazapine, and (3) 15 mg per day of mirtazapine
. The order of treatments was randomized for each subject, and orders were counterbalanced for the overall study.
MEASUREMENTS AND RESULTS
Each subject charted his or her sleep-wake schedule throughout the study and completed the Stanford Sleepiness Scale every 2 hours during the seventh day of each treatment period. Subjects were studied by laboratory polysomnography on the seventh night of each treatment period. With respect to placebo treatment, 4.5 mg of mirtazapine significantly reduced the AHI in all sleep stages to 52%, with 11 of 12 subjects showing improvement over placebo; 15 mg of mirtazapine reduced the AHI to 46%, with 12 of 12 subjects showing improvement over placebo
. Sleep fragmentation was reduced only by the higher dose of mirtazapine. Gross changes in sleep architecture were unremarkable.
Daily administration of 4.5 to 15 mg of mirtazapine for 1 week reduces AHI by half in adult patients with OSA
This represents the largest and most consistent drug-treatment effect demonstrated to date in a controlled trial. These findings suggest the therapeutic potential of mixed-profile serotonergic drugs in OSA and provide support for future studies with related formulations.
Mirtazapine also is associated with sedation and weight gain-2 negative side effects in patients with OSA. In view of the above, we do not recommend use of mirtazapine as a treatment for OSA
(05-01-2016 04:49 PM)tmoody Wrote: I'm starting this thread out of curiosity, and an open mind. I'm inviting people to share their forays into alternative or "fringe" therapies for sleep apnea--and of course their results.
In another thread, I've already told how I took up didgeridoo playing, which was, and is, great fun. But I can't say it has done anything for sleep. Yet.