Quetiapine reduces sleep apnea but triples attention lapses while driving

A popular antipsychotic drug was found to reduce obstructive sleep apnea (OSA); but it also led to impaired driving the next morning.

That’s according to a small, randomized controlled trial published in the Annals of the American Thoracic Society.

Researchers from Flinders University in Adelaide, Australia, conducted the study on 15 adults with OSA who also had difficulty maintaining sleep. Each participant underwent two nights of sleep studies, approximately one week apart, according to a press release.

Participants took 50 mg of quetiapine (Seroquel) at bedtime one night and a placebo the next night.

Quetiapine is a widely prescribed antipsychotic prescribed for schizophrenia, bipolar disorder, and depression. It is also often used off-label in low doses to treat insomnia, anxiety, and other sleep problems.

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Researchers monitored participants throughout the night; They looked at their breathing, brain activity, oxygen levels and leg movements.

A female driver yawns while sitting behind the wheel, illustrating the concept of falling asleep at the wheel. (iStock)

The study found that participants taking quetiapine increased their total sleep time by more than 40 minutes and experienced 45% fewer wakefulness throughout the night. Apnea-related events also decreased from 27 to 20 per hour.

Despite these improvements, the drug was found to slow reaction time behind the wheel compared to those taking a placebo. This was based on a driving simulator test and a 10-minute reaction time test administered within 30 minutes of waking.

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Those taking quetiapine experienced more than three times more lapses of attention and drifted out of the lane more often in the driving simulator.

Eleven out of 15 participants reported feeling sleepier in the morning after taking the drug, but roughly one in four were unaware of their own level of impairment. This was concerning because they may have been more likely to operate a tool or machine without realizing their reaction time was slowing down.

Other mild to moderate side effects included nausea, restless legs, and a sudden drop in blood pressure when standing. (iStock)

Other mild to moderate side effects included nausea, restless legs and a sudden drop in blood pressure when standing, which affected one in three people taking quetiapine.

The authors noted that the study had some limitations, including the small sample size. Participants were evaluated for one night only, and the laboratory setting of the study may not reflect real-world use of participants.

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Larger, longer-term studies are needed to confirm the findings before deciding whether to prescribe quetiapine for sleep apnea and insomnia, the researchers said.

Researchers, whose follow-up studies are ongoing, recommend that people avoid driving or other safety-critical tasks for at least 9.5 hours after taking quetiapine.

Women often metabolize these medications more slowly than men, which can affect both effectiveness and the risk of next-day side effects, one expert said. (iStock)

Ashley Curtis, PhD, director of the Cognition, Aging, Sleep, and Health (CASH) Laboratory at the University of South Florida, noted that some hypnotic drugs show gender differences in metabolism.

The expert, who was not involved in the research, cautioned that women generally metabolize these drugs more slowly than men, which could affect both effectiveness and the risk of next-day side effects.

“Future studies should carefully examine whether these new agents show similar gender-specific patterns to provide optimal dosage and safety recommendations,” he told Fox News Digital.

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According to Curtis, quetiapine’s effect on next-day cognitive function requires further research, especially among older adults.

“This population is already vulnerable to the cognitive and related side effects associated with polypharmacy, making it necessary to understand the potential trade-offs between sleep benefits and daytime functioning,” he added.

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According to Curtis, insomnia is often the result of “learned behavioral and cognitive factors” that persist over time.

“Even if medications are effective in the short term, behavioral interventions such as cognitive behavioral therapy for insomnia remain an important component of long-term management,” he said.

“This population is already vulnerable to the cognitive and related side effects associated with polypharmacy.”

Chelsie Rohrscheib, chief sleep specialist at Wesper, a sleep analysis company in New York, agrees that patients should not be alarmed by these findings.

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“But if they are taking quetiapine for sleep, especially if they have sleep apnea or wake up feeling groggy, they should talk to their doctor about whether the benefits outweigh the risks and whether other treatment options are appropriate,” said Rohrscheib, who was not involved in the study.

Fox News Digital has reached out to the drugmaker and study researchers for comment.