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A popular antipsychotic drug was found to reduce obstructive sleep apnea (OSA) – but also lead to impaired driving the next morning.
That’s according to a small randomized controlled trial published in the Annals of the American Thoracic Society.
Researchers at Flinders University in Adelaide, Australia, conducted a study on 15 adults with OSA who also had insomnia. Each participant underwent two sleep studies on the same night about one week apart, according to a press release.
Researchers at Flinders University in Adelaide, Australia, conducted a study on 15 adults with OSA who also had insomnia. Each participant underwent two sleep studies on the same night approximately one week apart. (Stock)
Participants took 50mg of quetiapine (Seroquel) at bedtime one night, and took a placebo the next night.
Quetiapine is a widely prescribed antipsychotic prescribed for schizophrenia, bipolar disorder and depression. It is also often used off-label in low doses to treat insomnia, anxiety and other sleep problems.
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The researchers monitored the participants throughout the night, monitoring their breathing, brain activity, oxygen levels and leg movements.
A female driver yawns while sitting behind the wheel, indicating the idea of falling asleep at the wheel. (Stock)
Participants who took quetiapine had more than 40 minutes more total sleep time and 45% fewer nighttime awakenings, the study found. Their apnea-related events were also reduced from 27 to 20 events per hour.
Despite this improvement, the drug appeared to have a slower reaction time behind the wheel compared to those taking a placebo. This was based on a driving simulator test and a 10-minute reaction time test, conducted within 30 minutes of waking up.
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Those taking quetiapine experienced more than three times the amount of attention and swerved out of their lane more often in the driving simulator.
Eleven of the 15 participants reported feeling sleepy the morning after taking the drug, but nearly one in four did not notice their level of impairment. This was a concern because they may have used a car or machinery without realizing that their reaction time had decreased.
Other mild to moderate side effects include nausea, restless legs and a sudden drop in blood pressure when standing. (Stock)
Other mild to moderate side effects include nausea, restless legs and a sudden drop in blood pressure when standing, which affected one in three people taking quetiapine.
The study had some limitations, including a small sample size, the authors noted. Participants were tested for only one night, and the research laboratory setting may not reflect the participants’ real-world use.
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Larger, longer-term studies are needed to confirm the findings before making decisions about prescribing quetiapine for sleep apnea and insomnia, the researchers said.
Pending follow-up studies, researchers recommend that people avoid driving or other safety-critical activities for at least 9.5 hours after taking quetiapine.
Women generally digest these medications more slowly than men, which can affect both effectiveness and the risk of side effects the next day, the expert said. (Stock)
Ashley Curtis, PhD, director of the Cognition, Aging, Sleep and Health (CASH) Lab at the University of South Florida, noted that certain addictive drugs show gender differences in metabolism.
Women generally digest these drugs more slowly than men, which can affect both effectiveness and the risk of side effects the next day, warned the expert, who was not involved in the study.
“Future studies should carefully examine whether these new agents show similar gender-specific patterns to ensure appropriate dosing and safety recommendations,” he told Fox News Digital.
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Quetiapine’s effect on next-day cognitive function warrants further investigation, particularly in older adults, according to Curtis.
“This population is already at risk of adverse effects related to polypharmacy, making it important to understand the potential trade-offs between the benefits of sleep and daytime activity,” he added.
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Insomnia is often the result of “learned behavioral and cognitive factors” that persist over time, according to Curtis.
“Even when medications are successful in the short term, behavioral interventions such as cognitive behavioral therapy for insomnia remain an important aspect of long-term management,” he said.
“This population is already at risk for adverse effects associated with polypharmacy.”
Chelsie Rohrscheib, chief sleep specialist at Wesper, a sleep analysis company in New York, agreed that patients should not be alarmed by the findings.
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“But if they’re taking quetiapine for sleep, especially if they’re having trouble sleeping or waking up depressed, they should talk to their doctor about whether the benefits outweigh the risks and what other treatments might be appropriate,” noted Rohrscheib, who was not involved in the study.
Fox News Digital has reached out to the drug manufacturer and the study’s researchers for comment.
