How NAC Can Help Improve Airway Function

Snoring usually coexists with obstructive sleep apnea (OSA) and has been linked with numerous adverse health outcomes, including the development of systemic hypertension, cardiovascular disease and abnormalities in glucose metabolism¹. It can lead to excessive sleepiness, cognitive dysfunction, impaired performance, and an overall reduction in quality of life.¹. Risk factors include age, excess weight, gender, craniofacial anatomy, familial or genetic predisposition, smoking, alcohol consumption and other medical conditions, including excess mucus formation from allergies. 

Personally, I have experienced increased mucus production associated with allergies, which has resulted in excessive nasal congestion and increased drainage in the back of my throat, especially at night. This has, at times, caused snoring and short apneic periods at night (as reported by my wife). 

When discussing this with my physician, he mentioned that he has had relief of his nighttime nasal congestion by using N-acetylcysteine (NAC). NAC is a mucolytic and potent antioxidant drug that acts directly as a scavenger of free radicals - especially oxygen radicals - and potentially influences several inflammatory pathways^{2, 3}. It is a well-tolerated drug that moderates clinging mucous secretions and enhances glutathione S-transferase activity. 

In addition to functioning as a mucolytic, it is used to loosen thick mucus in individuals with chronic obstructive pulmonary disease. It is also used to treat acetaminophen overdoses, for preventing alcoholic liver damage, and for protecting against environmental pollutants. In Germany and other European countries, it is the most common mucolytic drug purchased over-the-counter. Side effects can include gastric and intestinal upset. In addition, some research shows it can slow blood clotting, so it may not be recommended for patients scheduled for extractions or various types of oral surgery.

I currently take 600 mg of NAC every morning and have noticed a dramatic reduction in the amount of mucus produced at night. Since I started taking it, I have not had any reported incidents of snoring or apneic periods. I seem to be sleeping more soundly and waking more rested. While this over-the-counter drug may not work for everyone, it is something to consider when treating patients with sleep related issues who also self-report excess mucus production. 

(Click the link for more articles by Dr. Bob Winter.)  

Bob Winter, D.D.S., Spear Faculty and Contributing Author

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References

1. Punjabi NM. The epidemiology of adult obstructive sleep apnea. Proc Am Thorac Soc. 2008;5:136–143.

2. Sadowska AM, Verbraecken J, Darquennes K, De Backer W. Role of N-acetylcysteine in the management of COPD. International Journal of Chronic Obstructive Pulmonary Disease. 2006;1(4):425-434.

3. Mokhtari V, Afsharian P, Shahhoseini M, Kalantar SM, Moini A. A Review on Various Uses of N-Acetyl Cysteine . Cell Journal (Yakhteh). 2017;19(1):11-17.