Zanaflex making sleep apnea worse. Any ideas or options?

[Sarahsmom46]

I have a question about muscle relaxants i.e baclofen, zanaflex etc.  for spasms.  

I have spacisity (sp?) and it is so bad at night.  I've been taking zanaflex (tizanidine) for awhile now but never realized that it was contributing to my sleep apnea.

The nurses noticed that I was haping significant apnea when they did their nightly rounds while I was in hospital and now my daughter, who has come to help me out after getting out, says that the apnea really scares her. She wakes me up so I will not start choking.  

We tried an experiment and when I don't  take the zanaflex, then my apnea and snoring are not so bad.  Problem with that is that the pain from the spasms are keeping me awake.  

I'll ask my neuro about this next week, but in the meantime do you guys ahave any ideas or other options for muscle spasms other than using muscle relaxants?  

Hopeful there's another option.

Julie

[Sarahsmom46]

You bring up a very intereting idea about the CPAP vs the Bi-Pap. IF and only if my study shows that I needs some help at night, I am going to discuss the differences between the two.  

I have been told by the respiratory therapist that between the apnea and my weak diaphragm, that the Bi-Pap would be a better machine to use.

Another important statement your brought up is about what insurance compaines will pay for.  I have learned how if, for example, they buy you a walker - a simple metal framed walker worth a hundred bucks or so, that you aren't eligible to get another walker for like 5 years.  I guess that would hold true for a machine like a CPAP.   I'll keep this in mind, again if my tests show I actually will benefit from it.  

Thanks again Mary.  The information you gave was very helpful.

Julie

[twopack]

"Could luck" ? .........  Did I really say that??

Well at least if my mind and fingers are making errors they are going about it in a nice rhyming manner.  (rolls eyes at self).

Although drugs can never substitute for enough of the right kind of sleep, I was wondering if you use any medication to help fight MS fatigue.  The CPAP could only do so much.  The sleep specialist prescribed Provigil for me a couple of years before my MS was diagnosed.

Sometimes I wonder if Bi-Pap would work better for me these days.  With that you don't have to exhale against the air pressure being forced into your nostrils.  As my muscles fatigue, it seems like some nights I don't have the umph to exhale against that force.  I doubt insurance wants to help me buy another machine though.

Mary

[Sarahsmom46]

Thanks Mary and GG for your comments.  My daughter said she tried to imitate the breathing pattern I take on during the night and it makes her very dizzy.  Go figure why I am waking up in the morning feeling like I had just went to bed.  I probably am not even getting a couple of good hours of sleep.

I'm filling out the sleep study questionnaire that just came in the mail.  It seems more involved than the one I completed last time.  I'm glad too that I have someone around to take notice of what is happening when I am asleep.  Love that girl of mine. Al snores way worse than I do and he probably didn't even give it a moments notice.  

Thanks again you guys. I'll let you know how this turns out.

Julie

[Guitar_grrrl]

I had to ask my DH about this, LOL!  I've been on Baclofen since November '09, and he says I snore less, now, than before. Sleep apnea was never an issue, thank goodness!  I have been known to "snore like a freight train" according to both my DH and sister.

The Baclofen helps with my spasms, which I get day and night, but doesn't get rid of them completely.  I also had a three month period this spring when my spasm activity was significantly increased.  I attribute this to a probable flare.  I mentioned this to my neuro, and we both agreed not to do a course of SoluMedrol.  Sure enough, they've gotten less intense over the past couple of weeks.

Good Luck!

[twopack]

I only took Zanaflex two or three times but each time I noticed an increase in RLS that kept me awake instead of letting me sleep.  Therefore, I hadn't thought about it's potentail to increase snoring or sleep apnea.

But that's an interesting observation and.it kind of makes sense that muscle relaxants and/or anti-spasmotics would allow your jaw to drop back and increase symptoms that you may already lean toward.  It's fortunate you've had people around to notice the difference.

I'd be sure to mention these observations to the sleep specialist who is doing your study before you have it done.  It seems to me I remember instructions to go in 'drugless' but that doesn't make sense if it doesn't end up representing your normal sleep conditions, especially on a repeat test.  He may have a preference that you take the drug if it needs to be part of your nightly protocol.

I use CPAP and have found it fairly easy to get used to with the headpiece I use.  Some nights I only last part of the night with it but it's still an improvement.  It's amazing what you can make yourself adjust to when you know it will be helpful in allowing more normal, functional days.

I'd be interested to hear what you find out Julie.  Could luck in week two at work.

Mary

[Sarahsmom46]

Thanks for responding Michelle.  I have a sleep study scheduled for July 7th, my second test.  The last test wa borderline mild/moderate so I didn't have to use a CPAP.  I hope things are not as bad as they look right now because I am not sure how I'll do on one of these machines.  Fingers crossed.  

Like you, the zanaflex helped me fall asleep so I wasn't sure if I was just sleeping through the pain or the pain relief was helping me sleep.  I didn't know which was which until I stopped taking the med and found the spasms were still there and so was the pain.  

I'll talk to my neuro's office this week.   I need to be able to get enough sleep now that  I am back to work full-time.  We'll get it figured out.  

Take care and thanks again for your response.

Julie

[michelleric]

I have no idea about the sleep apnea part and the relationship with Zanaflex.  I just know that I take Zanaflex also at night, and it knocks me out cold. (Dont know if it is really helping with my leg/feet spasms, or just knocks me out so I dont know if I have them or not!

Ask your neuro about it. Perhaps there is another med that might be a better choice for you? Do you use a C-pap?

Michelle