A recent study reveals that quetiapine, a common antipsychotic, can reduce obstructive sleep apnea (OSA) but may also impair driving. This finding comes from a small trial published in the Annals of the American Thoracic Society.
Study Design and Results
Researchers at Flinders University in Adelaide, Australia, studied 15 adults experiencing both OSA and sleep maintenance issues. The participants underwent two overnight sleep studies about a week apart. One night they took 50mg of quetiapine before bed, and the other night, a placebo.
Quetiapine is typically used to treat schizophrenia, bipolar disorder, and depression. It’s also prescribed off-label at lower doses for insomnia and anxiety. The study monitored breathing, brain activity, oxygen levels, and leg movements during sleep.
Results indicated that quetiapine increased total sleep time by more than 40 minutes and decreased wakefulness by 45%. Apnea-related events dropped from 27 to 20 per hour.
Concerns Over Impaired Driving
Despite sleep improvements, reaction time slowed in those taking quetiapine, based on a driving simulator and reaction time test. More attention lapses and lane swerves occurred with quetiapine use. Eleven out of 15 participants felt sleepier the next morning, and one in four did not recognize their impairment level, which poses a risk for driving or machinery operation.
Other Side Effects and Considerations
Other side effects included nausea, restless legs, and a sudden drop in blood pressure. One in three people experienced these mild to moderate effects. Limitations of the study include its small sample size, a single-night evaluation, and a laboratory setting not reflective of real-world use.
The researchers caution against driving or performing safety-critical tasks for at least 9.5 hours after taking quetiapine, noting women metabolize these drugs more slowly than men, affecting efficacy and side effects risk.
Expert Opinions and Further Research
Ashley Curtis, PhD, from the University of South Florida, noted that sex differences in drug metabolism should be considered in future studies. She emphasized the importance of understanding the balance between sleep benefits and cognitive side effects, especially in older adults who may be more vulnerable due to polypharmacy.
Chelsie Rohrscheib, a sleep expert at Wesper, advised patients using quetiapine for sleep apnea or grogginess consult their doctors about risks and alternative treatments. Both experts stress that while medications may work short-term, cognitive-behavioral therapy is vital for long-term management of insomnia.