Clinical perspective: monitoring sodium oxybate-treated narcolepsy patients for the development of sleep-disordered breathing.
OBJECTIVE
While the symptoms of narcolepsy are often amenable to treatment with sodium oxybate (SXB), the respiratory effects of long-term SXB treatment have not been systematically studied. Recent reports have implicated SXB with several cases of worsening sleep-related breathing disturbances and accidental death. In addition, these patients are at risk for obesity, which may aggravate co-morbid obstructive sleep apnea.


METHODS
Based on a review of the literature and the clinical experience of the author, recommendations for the use of SXB in patients with sleep-disordered breathing have been developed.


RESULTS
Among narcolepsy patients with evidence of sleep disordered breathing during baseline polysomnography, SXB should be prescribed only to those patients who fully comply with nasal continuous positive airway pressure therapy. The respiratory status of other SXB-treated patients should be periodically evaluated with nocturnal oximetry.


CONCLUSIONS
Based on the currently available data, physicians prescribing SXB should remain vigilant for the possible development of sleep-disordered breathing during long-term treatment with SXB.
Feldman
Neil T
NT
St. Petersburg Sleep Disorders Center, Palms of Pasadena Hospital, St. Petersburg, FL 33707, USA. nfeld@msn.com
D000759:Adjuvants, Anesthesia / Q000009:adverse effects / Q000627:therapeutic use*; D016903:Drug Monitoring; D006801:Humans; D009290:Narcolepsy / Q000175:diagnosis / Q000188:drug therapy*; D012891:Sleep Apnea Syndromes / Q000175:diagnosis / Q000517:prevention & control*; D012895:Sleep, REM / Q000187:drug effects; D012978:Sodium Oxybate / Q000009:adverse effects / Q000627:therapeutic use*
D000759:Adjuvants, Anesthesia; D012978:Sodium Oxybate