Drug Disease and Drug Drug Interactions

© It is important to review patient medication profiles for drugs that may aggravate sleep disorders. Patients should be monitoredfor adverse drug reactions and potential drug-drug interactions. They should be assessed for adherence to their therapeutic regimens. Pharmacotherapy for sleep disorders should be individualized. Medications can be used commonly to treat several concomitant sleep disorders. Conversely, drug therapy may be effective for one sleep disorder and exacerbate another. For example, antidepressants may alleviate depressive symptoms but exacerbate symptoms of RLS. Medications that block dopaminergic transmission may worsen RLS symptoms. Smoking can worsen OSA, presumably by increasing upper airway edema. Alcohol and CNS depressants, including opiate analgesics, sedatives, and muscle relaxants, can worsen OSA, even in small doses, by reducing respiratory drive and relaxing the upper airway muscles responsible for maintaining patency. CNS depress ants should be avoided, and if they are necessary, they should not be administered before sleep. Drug therapy for sleep disorders should be patient specific, and careful consideration should be given to coexisting diseases, concomitant medications, and potential drug-drug and drug-disease interactions to optimize patient care and treatment.

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