In part 3 of this 4-part series, Michael Thorpy, MD, talks about advances in sodium oxybate medication formulations and how different formulations can help patients depending on their needs.
Various types of sodium oxybate medications provide options for patients who have sleep disorders, even those that need more or less sodium intake, says Michael Thorpy, MD, professor of neurology at the Albert Einstein College of Medicine, and director of the Sleep Disorder Center at Montefiore Medical Center.
What monitoring and educational measures should be in place for patients prescribed sodium-based sleep medications to ensure they maintain a balanced sodium intake and follow low-sodium guidelines effectively?
There are many patients who continue to take the sodium form of sodium oxybate, and not the low-sodium formulation. These patients need to be advised about the importance of limiting any extra salt intake. There are now 3 different forms of oxybate. The standard original form of sodium oxybate is a medication that's taken twice at night. Then there's a low-sodium formulation that's also taken twice at night. But there's a new formulation of sodium oxybate, which is a once-a-night formulation.
For many patients who have had difficulty in taking the medication in the middle of the night, they prefer the sodium oxybate that's given once a night. So those patients need to be advised that although there’s a higher salt content than would be ideal, they just need to limit the amount of salt that they take extra. But so far, we don't have any actual evidence that the extra salt intake associated with sodium oxybate has caused any increase in cardiovascular concerns, which is the major concern about the extra salt, as a potential that may cause an increase in cardiovascular disorders, such as hypertension/high blood pressure.
However, patients who have cardiovascular disorders or renal disorders or problems with excessive fluid retention would be better not to take the sodium formulation and would be better on the low-sodium formulation. Patients need to be advised that there are some medical conditions that they need to be aware of that would restrict them from taking the highest sodium content.
So, education about salt intake, medical disorders that may be sensitive for salt intake are important for recommendations in guiding patients who may be taking these types of medications.