| Popis: |
Introduction and objectives Long-term opioid use has been proposed as a risk factor for sleep disordered breathing with the concern that it may precipitate or exacerbate OSA. Prescribing of opioids is increasing but there are few reports of compliance in this sub–population of people treated with CPAP therapy. Some studies of people with sleep disordered breathing have shown very low levels ( Methods We performed a retrospective case review of people starting CPAP in 2016–17 financial year. People taking opiates were identified and controls sought using strict matching on oxygen desaturation index ODI (±1) from their diagnostic nocturnal oximetry. The responses to CPAP at follow-up, including mean and minimum oxygen saturations, ODI, Epworth Sleepiness Scale score (ESS), as well as compliance were compared for the opioid and non-opioid groups. Results From 1629 patients with OSA syndrome who started CPAP, 120 patients taking opioids were retrospectively identified for whom controls could be found. There was no difference in response to CPAP on ODI and ESS but patients on opioids had higher compliance measured as hours of use (table 1). Among the people taking opioids there was no correlation between CPAP compliance and either ESS (r=−0.18; p=0.11) or ODI (r=−0.09; p=0.51) at post treatment. In contrast these relationships were significant in controls; ESS (r=−0.36; p=0.0005) and ODI (r=−0.37; p=0.006). Conclusion Despite the sedative properties of opioids and their potential effect on sleep-disordered breathing, chronic opioid use did not affect the response to CPAP on ESS, ODI and nocturnal oxygen saturations, compared to matched, non-opioid taking OSA controls. Higher hours of use in these patients did not result in further improvement in ODI or ESS which may suggest that other factors rather than OSA per se may be implicated in residual ODI and ESS in opioid taking patients. |
