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Unread 03-16-2008, 04:23 PM   #1
mjl
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Default Suboxone & sleep apnea

I've been a SMT patient for almost 6 yrs and was recently diagnosed with sleep apnea. I'm posting this topic because sleep apnea is more common, dangerous and fatal then most people know. Many symptoms are similar to the (urban legend?) side effects often blamed on suboxone.
For the last 5 years my symptoms included morning headaches (sometimes lasting for days), waking up feeling exhausted, no motivation or energy, short term memory loss, feeling foggy & cloudy all day, always sleepy, inability to concentrate, depression, constant colds, flu's, pneumonia, joint pain, swelling, numbness in hands & feet, overall weakness, & nocturia (excessive night time urination). It would have been easy to say these were just side effects of suboxone, suboxone was losing its effectiveness or I was a total hypochondriac.
I consulted dozens of traditional & holistic Dr's, and took every possible blood test, MRI, head scan and alternative treatment. I quit caffeine & nicotine, tried diets, acupuncture, meditation, yoga, but nothing helped. I adjusted my sub dose between 32 mgs down to 3 mgs a day, but nothing helped.
Finally, last fall a friend suggested I get tested for sleep apnea. I assume since it primarily affects snorers & overweight people my collection of doctors never considered it. Way too late to shorten a long story, but I consulted a sleep specialist & did a few sleep studies. I was diagnosed with central sleep apnea. Basically your brain forgets to breathe while you're sleeping (as opposed to the more common obstructive sleep apnea which is caused by a blockage in the airway). With either type, people stop breathing hundreds of times per night, and aren't aware it's happening. You rarely get beyond stage one of the sleep cycle or any of the normal benefits from sleeping.
My test showed I'd stop breathing for up to 45 seconds so my body was in a constant state of oxygen deprivation. This caused the severe headaches & is also very bad on the internal organs among other things. The treatment options for sleep apnea suck, but it was a HUGE relief to know why I felt like a zombie & and I wasn't a hypochondriac .
Now I use a CPAP (constant positive airway pressure) machine every night and only require ~ 7 hours of sleep. Headaches are gone; memory is improving, and overall I feel great compared to a few months ago.
Unfortunately my sub Dr. & neurologist/sleep specialist think sub could be causing the sleep apnea since all opiates can suppress breathing. I checked with Reckitt Benckiser and their on-line data base of suboxone info, www.coretext.org, looking for a connection, but nothing has been published. I guess the only way to be certain in my case would be going off SMT, but that's not happening anytime soon.
I Hope no one else here has similar problems because it's incredibly frustrating. If you suspect you have sleep apnea, check out www.apneasupport.org for more information.
GL,
Mark
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Unread 03-17-2008, 12:06 PM   #2
NancyB
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Hi Mark, thanks for sharing that information. I'm glad your friend suggested the sleep studies. A family member of mine was just diagnosed with it too and is going through the CPAP adjustment phases now. (Not a bupe patient, late 60s, not overweight.) The same thing with you, a number of tests and couldn't find anything wrong until a different doctor suggested the sleep studies.

Hopefully she'll feel as well as you do once she's settled in with her CPAP.

Thanks again for the important information.

Nancy
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Unread 03-18-2008, 12:17 PM   #3
mjl
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Thanks Nancy. I thought this topic should be "on the record" here since most of the symptoms are the same as the supposed side effects of suboxone. I'm sure some of the SMT patients complaining of morning headaches, exhaustion, memory loss, foggy thinking, etc actually have some form of sleep apnea.
I hope your friend feel better quickly - Please refer her to the site I mentioned because the learning curve is pretty steep.
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Unread 03-18-2008, 07:53 PM   #4
erob
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I was diagnosed with sleep apnea long before I had any problem with opiates, am in my early 30s and thin, so I can rule those factors out as causes for sleep apnea. I tell you this because I think it's a pretty common affliction, and as Nancy said, many people who have it haven't even considered that they might. I agree that it's a great idea for people to look into whether sleep apnea or Suboxone is the cause of those lousy symptoms.
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Unread 03-18-2008, 08:46 PM   #5
hydra
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Thanks for the post Mark. My mother has sleep apnea. It has never occurred to me I might have it. But it wouldn't suprise me. I appreciate your thought provoking post.

I have every symptom you listed and have had some of them for a few years, long before I started suboxone. In fact, a lot of the symptoms you listed are the reason (among other things) I would take pills in the first place. I have looked for a solution to my aches and pains for a while now. Now I have something to think about. My mother and I are not overweight but we both snore. It sounds like this problem can effect many regardless.

Thanks again. I hope you continue to feel better with every passing day.

-Heidi
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Unread 03-18-2008, 10:10 PM   #6
mjl
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Thanks Heidi
By far the worst part of sleep apnea is always feeling totally exhausted - I'd wake up in the morning after 10 hours feeling as I hadn't slept a wink.[xx(]
If you suspect you have it too, please get it checked out because correcting it will change your life!
Unfortunately sounds like your Mom can reccommend a good sleep lab.
GL,
M
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Unread 03-26-2008, 08:44 AM   #7
pateralus9
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Mark,

This is atually my very first post on this site. I'm actually very nervous about quitting opioids and haven't talked to anyone about it, really, and I'm hoping to get started on sub soon from a doctor near me.

The reason I'm posting here first is because I am a polysomnographic tech (sleep study guy) and I have treated many people with central or complex sleep apnea. I know it can be frustrating to have, especially since CPAP or BiPAP doesn't work for many who have CSA due to the non-obstructive nature of the disease. I wanted to mention to you, though, and perhaps you could ask your doctor about adaptive servoventilation. There are new PAP machines now that use this "AutoSV" feature, which basically forces you into a breathing rate, for example of say 12 breaths per minute, and a set rise time of about 2 seconds inspiration and 4 seconds expiration. The dfining feature, though, is that the machine, instead of staying at a continuous pressure like CPAP, actually corrects central sleep apnea by forcing breath at a constant rate, while increasing Max IPAP (Inspiratory pressure) on a breath-to-breath basis. This means that if the machine notices you having a central apnea, it will increase support gradually during the apnea to adjust in real time for your lack of breathing.

The only problem I see here is that many insurance companies are currently difficult to presuade to pay for AutoSV due to its high cost comapred to CPAP or BiPAP. Most doctors would also like to rule out the possibility of both CPAP & BiPAP as options before trying this type of treatment. You may want to ask your doctor about this, though, as just about a onth ago I had a patient with very severe CSA with mixed apneas as well, who performed wonderfully under AutoSV titration.

Hope this somehow helps and thanks for listening!

Pat
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Unread 03-26-2008, 12:23 PM   #8
mjl
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Pat,
Thanks for taking the time to mention the SV machine. I got one a few months ago & it has worked perfectly.
I hope your able to get with a sub dr. asap - I think you'll be relieved how good you will feel after starting SMT.
GL!
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Unread 03-26-2008, 10:23 PM   #9
Warrior_Ali
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I think i also got this sleep apnea.

I dont know if its related to sub but i never had it before, i am in good shape, dont put blanket over my face, excerise all the time but i feel like am suffocating when sleeping or just abt to go to sleep, also i feel like my head is about to explode just before i fall asleep, i really hope, pray & wish they aint sub related because if they are then what esle will be related to sub.

Sub is relatively new kind of drug & i dont think many know the effects of long-term use as not many ppl are or have been on long-term use but this is all guess work, it seems a coincidence that the few problems i have now while on sub i never had before sub, i.e tooth aches/infection/extractions, sleep problems such as breathing, head exploding, back pains etc, but cud be all hearsey but still this doesnt put my mind at peace regarding sub.

Evertime i see doctors about this they all seem to confused & suprised like they dont know why its happening as am such a fit man (apart from the attraction lmao lol), healthy, taking care of myself as brushing my teeth, having proper sleep at right time, early to be early to rise and the docs just dont know, i might have to get blood tested or something but they all know am on sub but docs cant really know if any problem as such is related to sub can they as they only prescribe doses & do short coures and as i said sub is still relatively new to most docs around the World.
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Unread 03-27-2008, 06:51 AM   #10
Steve Musicman
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MJL,

I have had a sleep disorder for 20 some years and have not been on any drugs what-so-ever until last year when I injured my back and went on my mix of Codeine pills. I hjave sice been on Subs to kick the Codeine habit. I was to every doctor and sleep disorder unit in my areas, had a zillion tstes and I think I invented/associated the word Fog with the disorder some 15 years ago when I was trying to explain the feeling I had the following day. I didn't have it every day but 3-4 tims a week and it was enough to make you want to kill yourself. After I came up with the description Fog all of a sudden I saw everyone using it on the internet. Not that I'm bragging about it, just that there was no good explaination of just how I felt. Anyway, when I went on the Codeine it took it right away and all the time I was on the Codeine I never had the fog, not once, nor do I get it on subs so in my opinion its not the subs that will effect your sleeping issue. Your descriptin of sometimes lasting for days), waking up feeling exhausted, no motivation or energy, short term memory loss, feeling foggy & cloudy all day, always sleepy, inability to concentrate, depression, was me exactly.

I still can't sleep but when I do get sleep I do not get the fog. If you're on the CPAP and it's worked for you until you starting taking subs, I can't understand the connection due to my own experiences. The CPAP never worked for me, and it was a combination of sleep meds that finally worked so I would get the 3-4 hours of deep REM sleep I needed not to feel he fog. Like now, its 3:40 in the morning. I went to bed at 10:30 and no fog. I would like to sleep to 5 or 6 but it just is not happening. However, I do not wake up with the fog after using subs. It has to be something else that's not letting you get into your REM which causes the fog in the first place. Again, this is just my opinion and experience. Since everyone is different my story could have nothing to do with what you're going through, but I wanted to share it with you.
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Unread 03-28-2008, 03:37 AM   #11
mjl
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Steve
My posts may have been a little long & confusing - sub wasn't causing my sleep apnea but it could be contributing to it because it can slow breathing. I was on sub for many years prior to being diagnosed with sleep apnea & many people tried to convince me sub was causing the foggy feelings & exhaustion. Luckily CPAP has helped me tremendously & I'm still doing great with SMT.
I understand your situation because I've done a lot of research on sleep apnea since being diagnosed. Some people get much better quality of sleep taking some type of sleep aid like ambien. If you feel much better on codiene and/or sub (not depressed) maybe they are acting as an anti-dep., and you feel better with an opiate in your system? Aside from the opiate addiction, I also take sub for the anti-D qualities.
Ali - sub has actually been used in the good old USA for 7 or 8 years and in Europe for decades. Sounds like the timing of your problems have more to do with coming OFF of you DOC then starting ON sub. The back ache is a dead give away.
GL
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