Apnea inducing drugs

High Opioids (narcotic analgesics)

Suppress respiratory centers; increase central/mixed apneas.

Morphine, Oxycodone, Hydrocodone, Fentanyl, Tramadol, Methadone

High Benzodiazepines & Barbiturates

Reduce airway tone, lengthen apneas, increase arousal threshold.

Diazepam, Lorazepam, Clonazepam, Alprazolam, Temazepam

Moderate Z-drugs (non-benzodiazepine hypnotics)

May raise arousal threshold; effect varies by dose/individual.

Zolpidem, Zopiclone, Eszopiclone

Moderate Muscle relaxants

Decrease pharyngeal tone, worsen upper airway obstruction.

Baclofen, Tizanidine, Cyclobenzaprine

Moderate Sedating antipsychotics

Weight gain + sedation may exacerbate OSA.

Olanzapine, Clozapine, Quetiapine, Risperidone

Moderate Sedating antihistamines

Nighttime sedation and pharyngeal relaxation.

Diphenhydramine, Chlorpheniramine, Promethazine

Caution Gabapentinoids

Respiratory depression risk, esp. with opioids or sedatives.

Gabapentin, Pregabalin

Caution Testosterone / Androgens

Reports of worsening OSA, possibly via weight or airway changes.

High Anesthetics / procedural sedatives

Suppress breathing, obstruct airway; require close monitoring.

Moderate Alcohol

Relaxes airway, increases obstructive events, esp. late night.

Disclaimer: For educational purposes only. Always consult your physician before changing medications.

Consultation about Sleep Apnea & Medications

Apnea inducing drugs

Medications That Can Worsen Sleep Apnea

High Opioids (narcotic analgesics)

High Benzodiazepines & Barbiturates

Moderate Z-drugs (non-benzodiazepine hypnotics)

Moderate Muscle relaxants

Moderate Sedating antipsychotics

Moderate Sedating antihistamines

Caution Gabapentinoids

Caution Testosterone / Androgens

High Anesthetics / procedural sedatives

Moderate Alcohol

Comments

Dr Farhad Emadi

Apnea inducing drugs

High Opioids (narcotic analgesics)

High Benzodiazepines & Barbiturates

Moderate Z-drugs (non-benzodiazepine hypnotics)

Moderate Muscle relaxants

Moderate Sedating antipsychotics

Moderate Sedating antihistamines

Caution Gabapentinoids

Caution Testosterone / Androgens

High Anesthetics / procedural sedatives

Moderate Alcohol

Comments