Opioids Cause Central and Complex Sleep Apnea in Humans and Reversal With Discontinuation: A Plea for Detoxification
| Autor: | Sanjiv Patel, Shahrokh Javaheri |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
Adult
Pulmonary and Respiratory Medicine Complex sleep apnea Central sleep apnea Polysomnography medicine.medical_treatment Case Reports 03 medical and health sciences 0302 clinical medicine 030202 anesthesiology Detoxification medicine Humans Obesity Continuous positive airway pressure Sleep Apnea Obstructive Continuous Positive Airway Pressure medicine.diagnostic_test business.industry Opioid-Related Disorders Chronic pain medicine.disease Sleep Apnea Central respiratory tract diseases Discontinuation Analgesics Opioid Treatment Outcome Neurology Anesthesia Female Neurology (clinical) business 030217 neurology & neurosurgery |
| Zdroj: | Journal of Clinical Sleep Medicine. 13:829-833 |
| ISSN: | 1550-9397 1550-9389 |
| DOI: | 10.5664/jcsm.6628 |
| Popis: | Central sleep apnea (CSA) and continuous positive airway pressure (CPAP) emergent CSA are common in patients for whom opioids have been prescribed for chronic pain management. It is not known if opioids are the potential cause of CSA. We report the case of a patient who underwent multiple full nights of polysomnography testing while on opioids, off opioids, and with various positive airway pressure devices. While on opioids, the patient had severe CSA that persisted during both CPAP and bilevel titration but was eliminated with adaptive servoventilation therapy. Some time later, opioid use was discontinued by the patient. Repeat polysomnography showed resolution of the sleep-disordered breathing. Later—while the patient was still off opioids—she had gained weight and become symptomatic; polysomnography showed obstructive sleep apnea without CSA. This time, therapy with CPAP showed elimination of sleep apnea without emergent CSA. These data collectively indicate that opioids were the cause of CSA as well as emergent CSA. |
| Databáze: | OpenAIRE |
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