Quetiapine’s Impact on Obstructive Sleep Apnea and Driving Ability

A study conducted by researchers from Flinders University in Adelaide, Australia, has highlighted the effects of an antipsychotic medication on obstructive sleep apnea (OSA) and driving ability. Published in the Annals of the American Thoracic Society, this randomized controlled trial involved 15 adults suffering from OSA and experiencing sleep difficulties.

The study utilized two overnight tests to assess the impact of taking 50mg of quetiapine (Seroquel) before bedtime. This medication is commonly prescribed for schizophrenia, bipolar disorder, and depression. Additionally, it is used off-label to treat insomnia and anxiety.

Results showed that participants who took quetiapine enjoyed an increase in total sleep time of over 40 minutes and experienced 45% less wakefulness. The frequency of apnea-related events decreased from 27 to 20 events per hour.

Driving Risks Identified

Despite these positive effects on sleep, quetiapine was associated with impaired driving performance. Through simulator and reaction time tests conducted within 30 minutes of waking, researchers found that reaction times were slower compared to those who took a placebo. Participants had more attention lapses and increased instances of swerving.

“Eleven of the fifteen participants reported feeling sleepier the next morning,” the study revealed.

This presents a concern as individuals may not recognize their level of impairment, raising risks of operating vehicles or machinery with slowed reaction times.

Other Side Effects and Study Limitations

Quetiapine use also resulted in mild to moderate side effects. These included nausea, restless legs, and a sudden drop in blood pressure upon standing.

The study’s limitations include its small sample size and laboratory setting, which might not accurately reflect real-world usage. Evaluating participants over just one night also restricts the extent of findings. Larger studies are necessary to substantiate these results.

Recommendations for Further Studies

Pending further inquiry, researchers advise avoiding driving or performing safety-critical tasks for at least 9.5 hours after taking quetiapine. Ashley Curtis, PhD, emphasized that metabolism differences between sexes could affect drug efficacy and risks. Future research should explore sex-specific patterns in medication effects.

Curtis commented, “Understanding potential trade-offs between sleep benefits and daytime functioning is crucial, especially for older adults vulnerable to cognitive side effects.”

Chelsie Rohrscheib, from Wesper in New York, recommended discussing the balance between benefits and risks with a doctor, particularly for those using quetiapine for sleep apnea.

Incorporating non-medication strategies such as cognitive behavioral therapy is essential for sustainable insomnia management. Further studies will help ensure informed decisions about quetiapine’s use.