Mirapex and Sleep Apnea

[Frustrated]

I believe that the drug Mirapex I was taking for RLS caused sleep apnea. I am getting off the medication but was put on a CPAP machine. I asked my doctor about the connection and he said he didn't know of any connection. Does anyone have any scientific knowledge that links this drug to sleep apnea (not just difficulty breathing because that's not good enough for my doctor)? I have other severe side effects from this drug (1mg. dosage) so I'm pretty sure the breathing issues I'm having are related. Thanks in advance for your help. I need to educate my doctor.

[ViewsAskew]

I believe that the drug Mirapex I was taking for RLS caused sleep apnea. I am getting off the medication but was put on a CPAP machine. I asked my doctor about the connection and he said he didn't know of any connection. Does anyone have any scientific knowledge that links this drug to sleep apnea (not just difficulty breathing because that's not good enough for my doctor)? I have other severe side effects from this drug (1mg. dosage) so I'm pretty sure the breathing issues I'm having are related. Thanks in advance for your help. I need to educate my doctor.

I do not know of this happening. That said, pramipexole (Mirapex) can be very congesting for some of us. My nose is so plugged up I sometimes awaken in a panic - unable to breath through my nose and gulping air. I don't know if that would be confused for apnea. I just looked at several respected sites that list side effects, such as Mayo Clinic and NIH - I didn't see apnea listed, so it must not be common if it has been reported (these sites do not report every possible side effect, just the more common ones and the ones that are very severe). I'm not sure where you could see a complete list of side effects.

You may already know - 1 mg of pramipexole is much too high of a dose, according to many WED/RLS experts. They used to prescribe doses that high until they realized it can cause severe augmentation (the symptoms are worsened from the drug).

[badnights]

Frustrated, if you have gained weight from impulsive eating caused by the pramipexole, it may be that the sleep apnea is developing in response to the increased weight, which is a known risk factor. That would make the pramipexole indirectly responsible for the apnea (in combination with a genetic predisposition).

[philfs]

I have found that pramipexole has been giving me trouble breathing too! I wanted to see if anyone else has had suspicion of this problem and recently posted before seeing this. I've been living with RLS/WED for 10 years but have never been diagnosed with Apnea of any kind. Then after switching to pramipexole as my primary treatment I had another sleep study done and they discovered severe apnea - seemingly out of nowhere. I'm wondering if the drug has helped to create this apnea problem? - I also can not run/exercise now very well because I'm so out of breath. Have you gotten to the bottom of this possible side effect?
philfs

Posts: 1
Joined: Sun Dec 15, 2013 6:53 pm

[EeFall]

I have found that pramipexole has been giving me trouble breathing too! I wanted to see if anyone else has had suspicion of this problem and recently posted before seeing this. I've been living with RLS/WED for 10 years but have never been diagnosed with Apnea of any kind. Then after switching to pramipexole as my primary treatment I had another sleep study done and they discovered severe apnea - seemingly out of nowhere. I'm wondering if the drug has helped to create this apnea problem? - I also can not run/exercise now very well because I'm so out of breath. Have you gotten to the bottom of this possible side effect?
philfs

Posts: 1
Joined: Sun Dec 15, 2013 6:53 pm

It is not unusual for people with sleep apnea to have RLS or the other way around. Did you gain any weight taking Mirapex? Added weight can contribute to sleep apnea as does a large neck size. I think my doctor mentioned a neck size of over 17 1/2". There are different kinds of sleep apnea. One is obstructive sleep apnea where your tongue can actually block the air passage during sleep, also fatty tissue can do the same. Then there is central apnea where the brain signals are not working correctly and you can start and stop breathing during the night because of that.

I was diagnosed at the same time with sleep apnea and RLS, although my sleep apnea was worse at the time. Now my RLS is much worse although I now have central apnea too, as I started out with obstructive sleep apnea only. One of my sleep doctors said the central apnea may have been caused by the methadone I have been taking for years.

By the way, a 1 mg dose of Mirapex is a huge dose. .125 to .25 mg is considered a regular dose.

[ViewsAskew]

I have found that pramipexole has been giving me trouble breathing too! I wanted to see if anyone else has had suspicion of this problem and recently posted before seeing this. I've been living with RLS/WED for 10 years but have never been diagnosed with Apnea of any kind. Then after switching to pramipexole as my primary treatment I had another sleep study done and they discovered severe apnea - seemingly out of nowhere. I'm wondering if the drug has helped to create this apnea problem? - I also can not run/exercise now very well because I'm so out of breath. Have you gotten to the bottom of this possible side effect?
philfs

Posts: 1
Joined: Sun Dec 15, 2013 6:53 pm

Pramipexole makes me very congested. I can't breathe through my nose. But, it goes away within a few hours of waking.

I don't know if that would be enough to cause apnea or if that's what is going on with you. If I were you, I'd want to stop it for a few days and see what happens. If you can exercise and run again, you may have an answer. Sometimes, for whatever reason, drugs just don't get along with a person - even if no one else has those side effects.

[Rustsmith]

In addition to Obstructive Sleep Apnea (OSA) and Central Sleep Apnea EeFall described, there is another sleep disordered breathing condition that is sometimes referred to as Upper Airway Restriction Syndrome (UARS). UARS is somewhat controversial in that some doctors say that it is simply mild OSA while others point to distinct differences between UARS and OSA. With UARS, rather than the outright stoppage of breathing found in OSA and CA, the body detects a developing breathing restriction and causes the individual to momentarily awaken. This creates Respiratory Event Related Arousals (RERAs) that you may not even be aware of, but will disrupt sleep continuity. The "classic" description for UARS patients is also quite different from the older, overweight male of OSA. The factors generally include low BMI, younger (~30) females, low blood pressure with symptoms of postural hypotension, a narrow face and smaller necks, and frequently issues with GERD and/or chronic fatigue syndrome. Unfortunately, due to the controversies associated with the diagnosis, most sleep labs are not set up to properly detect UARS and most insurance companies will not cover treatment even if properly diagnosed.

Another difference between OSA and UARS is theorized to be a difference in the sensitivity of the nervous system. It has been shown that the nerves in the throat of OSA patients have some damage, presumably due to years of snoring. For UARS patients, this damage has not been found and it is theorized that they may even be hypersensitive to pending air flow restriction. It is this hypersensitivity that causes the awakenings.

UARS can also be caused by flow restrictions in the nose rather than just the throat. Sinus issues, a deviated septum or simply congestion from a cold will cause UARS type sleep disruptions. If pramipexole is causing your nasal congestion, then this might be related.

As you might guess, I have both UARS and WED.

[peanut1]

I was just diagnosed with obstructive sleep apnea and I'm thin as a rail with a thin neck. The sleep neuro said some of the meds do worsen apnea. I didn't ask which ones they were.

[badnights]

peanut: the opioids, if you're on them

[peanut1]

thanks Badnights! I take clonazepam and gabapentin.

[badnights]

Oh - no opioids.

[philfs]

I have stopped taking Mirapax now for 4 weeks. I weaned my self off of it - and it was very hard. But I have to report that my Sleep Apnea is GONE. I do have the original symptoms of RLS - (not half as bad as while on the Mirapax) but the sleep apnea which was killing me continuously decreased with my dosage and now it is gone. Hallelua! Just wanted to pass this one personal experience on. The Mirapax was definitely causing Apnea in me. Good riddance!

[ViewsAskew]

I have stopped taking Mirapax now for 4 weeks. I weaned my self off of it - and it was very hard. But I have to report that my Sleep Apnea is GONE. I do have the original symptoms of RLS - (not half as bad as while on the Mirapax) but the sleep apnea which was killing me continuously decreased with my dosage and now it is gone. Hallelua! Just wanted to pass this one personal experience on. The Mirapax was definitely causing Apnea in me. Good riddance!

Fascinating! And how lucky for you to figure that out.

What are you going to do to control the WED? Or just live with it?

[cmoore]

I have been diagnosed with sleep apnea as well....I believe Mirapex caused this.

[Polar Bear]

Did you have any symptoms of sleep apnea prior to taking mirapex.
Have you spoken to your dr about this.