Close Server: KOPWWW05 | Not logged in


Welcome to Health Care POV | sign in | join
Adventures in Sleep

Sleep Aids in CPAP Titration: What are ENTs taught?

Published February 9, 2012 4:25 PM by Penny Mehaffey
Penny Mehaffey, RPSGTFrustrated.  Yep, that would be the best way to describe me right now. And why am I frustrated you may ask? 

Well, I recently had a patient who told me that he has insomnia and cannot go to sleep before 4 a.m. no matter how early he goes to bed. Said patient needs a CPAP titration and, anticipating the problems associated with his complaints, I asked his doctor about a sleep aid for the night of the study. Here's what frustrated me: the doctor said no.

He proceeded to tell me that sleep aids are contraindicated in obstructive sleep apnea and that he could not order a med for this patient. What? Did he just say that? What's wrong with him? I will tell you what's wrong: He is an ENT doc, not a sleep doc. 

I read a study in ENTtoday with three control groups that found that...wait for it...there is not significant evidence to support that use of a sleep aid to help users acclimate to CPAP nor does a sleep aid increase the long-term use of CPAP.  I wonder how many of that group fit the description of this patient, moderate to severe OSA with insomnia and possible delayed sleep phase?  The article did give a nod to the use of sleep aids in specific circumstances that were not really specified.

While I respect a doctor's right to treat his patients his way,  I am really aggravated to think this patient will most likely come for the titration study, not sleep, leave with an unacceptable titration, and probably have to repeat it.  I personally have seen the benefit of using a sleep med to help CPAP users adjust.  I am so accustomed to sleep medicine's way of doing things (which I believe is the right way) that I just can't believe someone would choose the probability of failure. 

I should have asked the sleep doc.

Anyone have any advice to offer?

posted by Penny Mehaffey
tags:

2 comments

I am unfamiliar with SOMNO BLISS but I do have experience with Melatonin and a product called BIO Zzzz.  From time to time, I have used both at home with good results.  I was just taken aback with the verocity the ENT semed to have toward a sleep aid and how different the views are between sleep & ent..of course anyone with untreated sleep apnea should not take these types of meds..I have an ENT speakking to my A.W.A.K.E support group next month.  I plan to open the discussion with him.

PENNY March 17, 2012 5:04 AM

You can always recommend the patient use a non prescription sleep aid, such as SomnoBliss, which is an herbal blend of proven sleep inducing ingredients.  We have found that for patients who have a problem acclimating to the wearing of a CPAP mask, were able to better tolerate the transition by using SomnoBliss.

Craig Meyer February 21, 2012 7:08 AM

leave a comment



To prevent comment spam, please type the code you see below into the code field before submitting your comment. If you cannot read the numbers in the image, reload the page to generate a new one.

Captcha
Enter the security code below:
 

Search

About this Blog


    Adventures in Sleep
    Occupation: Sleep technicians
    Setting: Various sleep facilities
  • About Blog and Author

Keep Me Updated