Chronic opioid use: a risk factor for central sleep apnoea and successful therapy with adaptive pressure support servo-ventilation

A Fahim, AO Johnson
2012 The Journal of the Royal College of Physicians of Edinburgh  
Sleep apnoea is a global health problem with significant morbidity. Obesity is a well-known risk factor for this condition, however chronic intake of opioids as a risk factor for central sleep apnoea is under-recognised. We report a case of a 47-year-old man who developed significant sleep-disordered breathing secondary to opioid use for chronic pain. A sleep study demonstrated a picture of complex sleep apnoea with a prominent central sleep apnoea component. He had no significant improvement
more » ... icant improvement with conventional continuous positive airway pressure therapy. However, adaptive servo-ventilation had a dramatic effect on his symptoms and compliance. This case highlights the significant risk of central sleep apnoea with opioid use and illustrates the importance of adaptive servo-ventilation in the management of sleep-disordered breathing secondary to impaired central respiratory drive. 11 13 3 N/a: Not applicable Central sleep apnoea associated with chronic opioid use J R Coll Physicians Edinb 2012; 42:314-6 © 2012 RCPE 316 clinical ConCluSion This case highlights the potential harmful effect of chronic opioid intake (at a modest dose) on sleeprelated breathing. Moreover, it demonstrates the value of ASV in the management of complex sleep apnoea with a prominent CSA component. The exact pathophysiological mechanisms of narcotics-induced sleep disruption and ASV need to be elucidated in greater detail in long-term prospective studies to improve management of this clinical issue. A Fahim, AO Johnson J R Coll Physicians Edinb 2012; 42:314-6
doi:10.4997/jrcpe.2012.407 pmid:23240117 fatcat:qufmaofubbb3pfuedtkoyb76z4