Obstructive sleep apnea (OSA) happens when the muscles in your throat relax too much during sleep, causing your airway to narrow or close and briefly cut off your breathing.

That’s why over-the-counter (OTC) medications that cause drowsiness or relax your central nervous system merit caution in people with sleep apnea.

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“In sleep apnea, the muscles in your upper airway are already more relaxed than normal as you drift off, and that relaxation deepens even further during REM sleep,” says Safia S. Khan, MD, an associate professor of neurology at UT Southwestern Medical Center and a sleep disorder specialist in Dallas. That’s what causes airflow to become reduced or blocked, and your oxygen levels to fluctuate, during a typical apnea episode, she says.

A sedating medication like a sleep aid adds another layer on top of that: It increases that relaxation of the muscles, says Dr. Khan. “It can make the airflow further reduced by way of increasing the upper airway collapse. Taking a sedative medication when you have untreated sleep apnea can be actually dangerous for you,” she says.

Exactly how dangerous is unclear, following research examining the role of hypnotic medications as a possible treatment for obstructive sleep apnea. It may be that they’re less risky than previously thought.

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Nonetheless, if you have OSA, it’s worth discussing these seven common OTC medications with your doctor before use to make sure their benefits outweigh their risks for you.

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