Two Pills for Snoring?

This is something I've written about before, but here's another study that shows how taking a nasal decongestant along with something that helps to empty your stomach faster can help with snoring or obstructive sleep apnea. A recent study published in the Journal of Clinical Sleep Medicine reported that the combination of phenylephrine (a nasal decongestant) and domperidone (a medication that helps to empty the stomach) significantly improved snoring as well as oxygen drops in the middle of the night. Seventeen of 23 subjects reported elimination of snoring and apneic events.


This makes sense, since snoring and obstructive sleep apnea involves a combination of inflammation and obstruction. It's been shown that stomach juices can literally be suctioned up into the throat (and nose) during any obstructive event, whether or not it qualifies as an apnea. Digestive enzymes, bile, bacteria, and acid can cause inflammation and swelling in the upper breathing passageways, including the nose and throat.


By definition, all people who snore or have sleep apnea will have some degree of nasal congestion, since there's structural anatomic narrowing due to smaller jaws, as well as inflammation from allergic as well as neurologic causes. If your nose is stuffy, a vacuum effect is created downstream as you breathe in, causing the tongue to fall back and obstruct your breathing more easily.


This is why whenever you do anything to open up your nose (decongestants or Breathe Right strips), some people sleep much better (about 10%). 


Quite often, whenever people are given azithromycin (Z-Pak) antibiotic for routine conditions like a throat infection or sinusitis, they feel dramatically better, even if they never had an infection. One interesting property of azithromycin is it's known anti-inflammatory effects: it stimulate smooth muscles in your stomach and empties the contents downstream. But this only works in some people. You can imagine this is the same effect that domperidone has, but not as strong.


So if you combine a nasal decongestant and use something to empty your stomach faster, then this could lead to less inflammation in your throat and less of a vacuum effects that's created due to nasal congestion. This is also why not eating late or drinking alcohol is so important in this matter, along with optimizing nasal breathing through whatever means possible. Sometimes, taking a stomach acid reducer (like Prilosec or Nexium) can also help with sleep, since less acidic juices can cause less inflammation.


There are two problems with this study. The first is that they didn't do formal sleep studies. It was based on subjective questionnaires and oxygen monitoring. However, they do mention that they are working another study that will address this issue. I'm guessing that they will find significantly improved objective results with regard to the apnea hypopnea index and other measures. 


Secondly, the drug droperidone is not available in the US. There are other alternatives, but they all have significant side effects, since they all cross the blood-brain barrier (droperidone does not).


This combination of treatment options will probably be another option for people who snore or have obstructive sleep apnea, but currently, it won't achieve mainstream status until more studies are done, along with availability droperidone in this country (or something similar).


Did your sleep quality ever improve significantly after opening up your nose (using a decongestant or nasal dilator strips), or after taking a Z-Pak?

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One thought on “Two Pills for Snoring?

  1. Phenylephrine gives a lot of people insomina so that might not work for everyone.  Although I guess if it keep you wake then you won't have OSA ;-)