Ativan, Sleep Apnea, and Bad Craziness


N.B.:  Ativan is addictive but is not a narcotic.

Someone searched my blog for Ativan with sleep apnea:

DO NOT TAKE ATIVAN IF YOU HAVE SLEEP APNEAIt could kill you.

Ativan, also known as Lorazepam and Temesta, is a benzodiazepine; it is a narcotic.  It is used for the treatment of anxiety, insomnia and some other things.

The Physician’s Desk Reference (PDR) is the encyclopedia of all drugs sold over or under the counter.  When a drug has the potential to kill you, then the information in the PDR is printed with a heavy black box around it.  In the United Kingdom, Ativan has carried a “black box” warning for decades.  In the United States, it has not.  Maybe the FDA cares more about the drug companies making money than about you dying.

The problem is that Ativan interacts negatively with respiratory illnesses.  Sleep apnea is a respiratory illness, as are asthma, pneumonia and a bunch of other stuff.  Look Ativan up on Wikipedia and you’ll never again take the crap.  From Wikipedia:  The anxiolytic effects may also be detrimental to a patient’s willingness and ability to fight for breath.

  • Sleep apnea – Sleep apnea may be worsened by lorazepam’s central nervous system depressant effects. It may further reduce the patient’s ability to protect his or her airway during sleep.

Ativan, like all narcotics, is also addictive.  I had insomnia from the antidepressants and the doctor prescribed Ativan.  When the Ativan “stopped working” then the dose was increased.  In fact, it hadn’t stopped working:  I’d become addicted to it and needed a higher dose to get the same effect.  I didn’t know any of this.

At the same time, I had been diagnosed with mild obstructive sleep apnea.  While taking Ativan, my sleep apnea became much worse.  I started out using a CPAP (Comprehensive Positive Air Pressure machine) with a pressure setting of 7, which is pretty mild.  A CPAP blows room-air at a steady pressure through a mask and into your breathing passage while you sleep.  Without the CPAP, your breathing passage collapses and you wake up to catch your breath.

I was always in trouble with the CPAP.  I’d go back to the sleep lab several times a year and every time they would discover that the CPAP pressure needed to be re-set up, down or sideways.  A heated humidifier was added to the CPAP and that provided some relief but didn’t fix the problem.  Then I was switched to a BiPAP, i.e., a Bi-level Positive Air Pressure machine.  A BiPAP, instead of having steady pressure, has two settings, one for inhalation and the other for exhalation.  The BiPAP was better than the CPAP but I was still having intolerable problems.

Having bipolar disorder and sleep apnea is a bitch.  Failure to get enough oxygen to your brain while sleeping can trigger a depressive shift.  I’d get suicidal because the sleep apnea wasn’t being properly treated.  The big problem here is that the study of sleep disorders started out in psychiatry but somewhere along the line the pulmonologists decided to claim it as their own.  Now, if your sleep disorder is causing depression, your pulmonologist will not treat you, saying it is a problem for your psychiatrist, and your psychiatrist will not treat you, saying you need to see a pulmonologist.

Psychiatrist Dr. Nasri Ghaly resolved the problem by going to Stanford University to study sleep disorders, then opening his own two-bed sleep lab.  After he came back from Stanford he put a pad of questionnaires about sleep problems on the receptionist’s desk and told her that everybody who walked through the door was to fill one out.  He was shocked at what he found:  patients whom he’d been treating for psychiatric problems for years were reporting sleep issues that they’d never told him about.  Doesn’t everybody know that if you aren’t sleeping well then it can cause you to act crazy?  Tell your psychiatrist if you have sleep disturbances! 

Well, anyway.  I was having constant trouble and Dr. Ghaly had not yet gone to Stanford.  I had seen a cardiologist who had tested me for some breathing problem but hadn’t reported out the results.  The pulmonologist refused to see me until the cardiology results were in.  I was waking up in emotional torment, not to mention suicidal, in the middle of every night.  Finally, the strategy I used was to go the Emergency Room.  When you are in the ER, you immediately go to the top of your physician’s list of problems to be solved; he’s under enormous pressure from the ER to get you cleared out.  The ER physician—actually, a very nice physician assistant—called the cardiologist and pulmonologist and basically let them know they had to fix my problem NOW, and they did.

The cardiologist read the test results and cleared me, then the pulmonologist put me on an auto-BiPAP.  I did not know there was such a thing until that moment.  A regular BiPAP has two pressure settings; an auto BiPAP is controlled by a computer chip that re-sets the pressure with every breath.  It also has a SmartCard that electronically records a lot of data about how you use the machine.  When we pulled the SmartCard and had it read, what Dr. Ghaly and I discovered was that I had unstable sleep apnea!  Most people do okay with their machine on one setting for years; there’s no change in their usage and it doesn’t need to be re-set.  What we found was that my usage was changing during the course of every night.  My pressure might range from 12 to 21 in a single night.

I went through about five years of constant torment because my sleep apnea was neither properly diagnosed nor properly treated—not to mention that it cost the taxpayers upwards of ten thousand dollars.  I have been using the auto BiPAP for about three years now and have not once had a single problem.  I haven’t seen the pulmonologist, been back to the sleep lab, or gotten suicidal from poor oxygenation while sleeping.

There remains a single question:  If I had not taken Ativan, would I now be sleeping with a mask over my face every night?  There’s no way to tell but I for damn sure would never take Ativan again and I hope you won’t either.  You don’t need the grief.

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About annecwoodlen

I am a tenth generation American, descended from a family that has been working a farm that was deeded to us by William Penn. The country has changed around us but we have held true. I stand in my grandmother’s kitchen, look down the valley to her brother’s farm and see my great-great-great-great-great-grandmother Hannah standing on the porch. She is holding the baby, surrounded by four other children, and saying goodbye to her husband and oldest son who are going off to fight in the Revolutionary War. The war is twenty miles away and her husband will die fighting. We are not the Daughters of the American Revolution; we were its mothers. My father, Milton C. Woodlen, got his doctorate from Temple University in the 1940’s when—in his words—“a doctorate still meant something.” He became an education professor at West Chester State Teachers College, where my mother, Elizabeth Hope Copeland, had graduated. My mother raised four girls and one boy, of which I am the middle child. My parents are deceased and my siblings are estranged. My fiancé, Robert H. Dobrow, was a fighter pilot in the Marine Corps. In 1974, his plane crashed, his parachute did not open, and we buried him in a cemetery on Long Island. I could say a great deal about him, or nothing; there is no middle ground. I have loved other men; Bob was my soul mate. The single greatest determinate of who I am and what my life has been is that I inherited my father’s gene for bipolar disorder, type II. Associated with all bipolar disorders is executive dysfunction, a learning disability that interferes with the ability to sort and organize. Despite an I.Q. of 139, I failed twelve subjects and got expelled from high school and prep school. I attended Syracuse University and Onondaga Community College and got an associate’s degree after twenty-five years. I am nothing if not tenacious. Gifted with intelligence, constrained by disability, and compromised by depression, my employment was limited to entry level jobs. Being female in the 1960’s meant that I did office work—billing at the university library, calling out telegrams at Western Union, and filing papers at a law firm. During one decade, I worked at about a hundred different places as a temporary secretary. I worked for hospitals, banks, manufacturers and others, including the county government. I quit the District Attorney’s Office to manage a gas station; it was more honest work. After Bob’s death, I started taking antidepressants. Following doctor’s orders, I took them every day for twenty-six years. During that time, I attempted%2
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11 Responses to Ativan, Sleep Apnea, and Bad Craziness

  1. Pingback: Can the Villian Sleep Apnea Cause Dementia?

    • annecwoodlen says:

      I don’t know, but certainly lack of restorative sleep–not to mention adequate oxygen while you sleep–could give the symptoms of dementia, if not actual dementia.

  2. Susan weber says:

    Sorry for errors. Phone corrects itself. Medication hospital gave me was lorazepam which i have been on for 3 weeks now. I do have asthma and use 3 sprays daily for this as well as sleep apnea. I use a cpap for this. How dangerous is this medication for me and why then was i given it in the hospital when the doctors knew my medical conditions. Do you have any ideas what i could use instead for anxiety that will not affect the sleep panes.

    • annecwoodlen says:

      You should not, under any circumstances, ever take lorazepam, which is Ativan. You have two respiratory diseases–asthma and sleep apnea. In Great Britian, lorazepam carries a “black box” warning for respiratory disease. That means that if you have respiratory illnesses and take lorazepam/Ativan then it could kill you.

      In America, it says that you should tell your doctor if you have respiratory illness because he’s supposed to know enough to NOT PRESCRIBE LORAZEPAM/ATIVAN. Your jackass doctor doesn’t know what he’s doing. Stop taking the drug then file a complaint against your doctor with the NYS Dept. of Health, Office of Professional Medical Conduct, before he kills somebody with his ignorance.

      I have no idea what “sleep panes” are. To get to sleep at night, drink a cup of warm whole milk. Get a therapist, figure out what’s making you anxious, then fix it. What are you thinking about before you become anxious?

      You are relying on a machine to correct your spelling and drugs to “correct” your feelings. Take responsibility for yourself. It’s your life; only you can fix it. Exercise will help a lot with anxiety and sleep problems. Do it.

  3. Susan weber says:

    I was taking lyrica for fibromalaygia and starting getting suicidal thoughts so went off medication. I was admitted to hospital for one week band was pout on librarian to help with anxiety. Image asthma which i use 3 sprays for daily and i also use a clap machine for sleep panes. I have been on medication for almost 3 weeks now. How dangerous is this for me and what other anxiety medication could i take that would not average sameissuesfor me with the sleep panes.

    • annecwoodlen says:

      “Due to tolerance and dependence, lorazepam is recommended for short-term use, up to two to four weeks only.”
      Contraindications
      “Benzodiazepines, including lorazepam, may depress central nervous system respiratory drive and are contraindicated in severe respiratory failure. An example would be the inappropriate use to relieve anxiety associated with acute severe asthma. The anxiolytic effects may also be detrimental to a patient’s willingness and ability to fight for breath.”
      “Sleep apnea – Sleep apnea may be worsened by lorazepam’s central nervous system depressant effects. It may further reduce the patient’s ability to protect his or her airway during sleep.”

      http://en.wikipedia.org/wiki/Lorazepam

      I took Ativan/lorazepam every night for several years for insomnia. I had sleep apnea. I went through several years of torture; I was in the sleep lab several times a year to have my CPAP reset, but it never worked. CPAPs and BiPAPs are reset by doctor’s order. Finally a doctor put me on an auto BiPAP, which has a computer chip and resets with every breath. It also has a SmartCard that reads the usage of the auto BiPAP and that’s how we found out that I have unstable sleep apnea, that is, my draw on the machine ranged from 7 to 21 every night. That’s what Lorazepam/Ativan did to me.

      And from the National Institutes for Health:
      “Use of benzodiazepines, including lorazepam, both used alone and in combination with other CNS depressants, may lead to potentially fatal respiratory depression.”
      “Lorazepam should be used with caution in patients with compromised respiratory function (e.g., COPD, sleep apnea syndrome).”

      http://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=07cae057-a593-4e4d-a478-2d7fc9f06857

  4. Thanks for your great information, the contents are quiet interesting.I will be waiting for your next post.cpap-cleaning

  5. Good post. I definitely appreciate this site.
    Continue the good work!

  6. Amy lee says:

    Thank u for sharing this difficult experience with the world. U may have saved my mothers life. She is 85 and struggling for air every night while i wait for sleep study appointment. She has dimentia and has recently become increaingly withdrawn & less responsive. I Noticed that she was breathing better last night and hadnt had her usual evening ativan. Based on your experience I am going to discontinue the Ativan until i speak to sleep specialist.

    • annecwoodlen says:

      Be careful. Ativan is a benzodiazepine, which is a narcotic. I didn’t know that and therefore went through cold turkey drug withdrawal. Take her off the Ativan very slowly and carefully so that you don’t increase her suffering.

  7. So fantastic
    thank for share

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