Montelucast sodium is the chemical name for Singulair, a trademarked product of the pharmaceutical firm, Merck & Co. Montelucast is a medication prescribed for the prevention of allergic nasal congestion, or rhinitis, and asthma attacks. Breathing disturbances from either cause are likely to interrupt sleep or alter sleep quality. Effective treatment is expected to return peaceful, restorative sleep. Montelucast can also negatively influence sleep through other effects unrelated to breathing disorders.
Rhinitis
A 2004 research study reported in "The Journal of Allergy and Clinical Immunology," on the role of allergic rhinitis in sleep disturbances found that montelukast treatment significantly improved the quality of sleep. According to the study, montelucast inhibits chemicals called leukotrienes, which are produced by allergic reactions, from initiating a cascade of inflammatory tissue responses; therefore, typical discomfort and watery nasal discharges, which interfere with restful sleep, are prevented. The study documented that sleep disturbances contribute to decreased learning ability in school-age children, lower productivity at school for children and at work for adults, and generally degrade the quality of life for those affected. The study concluded that as a result of the improvement in sleep quality from montelucast, all other measures also improved.
Asthma
Children with untreated asthma experience breathing difficulty in their sleep and resultant degradation in sleep quality. A 2003 report in the "European Respiratory Journal," documented significant relief of night time labored breathing during sleep, as indicated by reduced nocturnal wheezing, by the end of a six week course of 5 mg/day of montelucast. Merck researchers report that the time of day at which montelucast is taken does not significantly alter its effect on day or nighttime benefits. A 2008 report by researchers at the Penn State College of Medicine published in "Allergy and Asthma Proceedings" documented significant reduction in daytime somnolence and fatigue related to improved sleep quality in montelucast-treated patients.
Psychological Actions
Neuropsychiatric symptoms can develop in montelucast users, according to a 2009 report published by the U.S. Food and Drug Administration (FDA). A warning was issued that leukotriene-blocking medications like montelucast may cause sleeplessness or other symptoms of psychological disturbances, such as anxiousness, irritability, aggression, and hallucinations, which may prevent or interrupt sleep, and depression, which can influence sleep patterns and lead to suicidal thoughts and behavior. The incidence of these reactions was not stated, but clinicians were advised to consider discontinuation of the medication if these reactions were observed.
