SouthernWorldwide.com – A common sleep medication, often prescribed for mental health conditions and sometimes used off-label for insomnia, has been found to impair driving ability the following morning, even if users don’t perceive the impairment.
This finding comes from a small study involving adults with obstructive sleep apnea (OSA) and difficulties staying asleep.
Researchers from Flinders University in Australia conducted the study with 15 participants who had OSA and sleep maintenance issues. Each participant participated in two overnight sleep studies, separated by about a week.
On one night, participants received a 50mg dose of quetiapine (Seroquel) before bed. On the other night, they received a placebo.
Quetiapine is a widely prescribed antipsychotic used for schizophrenia, bipolar disorder, and depression. It is also frequently prescribed at lower doses to manage insomnia, anxiety, and other sleep-related problems.
During the sleep studies, researchers monitored the participants’ breathing, brain activity, oxygen levels, and leg movements.
The study revealed that participants who took quetiapine experienced an increase of over 40 minutes in total sleep time and a 45% reduction in wakefulness during the night. Their sleep apnea events also decreased from an average of 27 to 20 events per hour.
Despite these sleep improvements, the drug appeared to negatively affect reaction times when driving. This was assessed using a driving simulator and a 10-minute reaction time test administered shortly after waking.
Participants who took quetiapine showed more than triple the number of attention lapses and were more likely to swerve out of their lane in the driving simulator compared to those who took the placebo.
Eleven out of the 15 participants reported feeling sleepier the morning after taking the medication. Worryingly, about one in four participants did not recognize their level of impairment, potentially leading them to operate vehicles or machinery without being aware of their slowed reaction times.
Other side effects reported by some participants taking quetiapine included nausea, restless legs, and a sudden drop in blood pressure upon standing, which affected one in three individuals.
The study’s authors acknowledged certain limitations, including the small sample size. The evaluation was conducted over a single night, and the controlled laboratory setting might not fully replicate real-world usage.
The researchers emphasized the need for larger, longer-term studies to confirm these findings before making definitive recommendations about prescribing quetiapine for sleep apnea and insomnia.
Pending further research, the study’s authors suggest that individuals should avoid driving or engaging in other safety-critical tasks for at least 9.5 hours after taking quetiapine.
Dr. Ashley Curtis, director of the Cognition, Aging, Sleep and Health (CASH) Lab at the University of South Florida, pointed out that some hypnotic medications are metabolized differently in men and women.
Women generally process these drugs more slowly than men, which can influence both their effectiveness and the risk of next-day side effects, she cautioned. Dr. Curtis was not involved in the study.
The impact of quetiapine on next-day cognitive function requires more investigation, particularly in older adults. Dr. Curtis noted that this population is already more susceptible to cognitive issues and side effects from multiple medications.
Understanding the balance between sleep benefits and daytime functioning is crucial for this vulnerable group, she added.
Insomnia is often rooted in persistent “learned behavioral and cognitive factors,” according to Dr. Curtis.
She highlighted that while medications can be effective in the short term, behavioral interventions like cognitive behavioral therapy for insomnia remain a key component for long-term management.
Chelsie Rohrscheib, a lead sleep expert at Wesper, a sleep analysis company, suggested that these findings should not cause undue alarm among patients.
However, she advised that if individuals are taking quetiapine for sleep, especially if they have sleep apnea or feel groggy in the morning, they should discuss the benefits versus risks with their doctor. She also recommended exploring alternative treatment options, if appropriate. Ms. Rohrscheib was not affiliated with the research.
