The relationship between opioid use and obstructive sleep apnea: A systematic review and meta-analysis
| Autor: | Tetyana Kendzerska, Randa Ahmad, Clodagh M. Ryan, Moussa Meteb, Richard S. Leung, Vanessa Luks, Aseel Ahmad, Gaspard Montandon |
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| Rok vydání: | 2020 |
| Předmět: |
Pulmonary and Respiratory Medicine
Adult medicine.medical_specialty medicine.medical_treatment MEDLINE CINAHL 03 medical and health sciences 0302 clinical medicine Physiology (medical) Internal medicine medicine Humans Continuous positive airway pressure Sleep Apnea Obstructive Continuous Positive Airway Pressure business.industry medicine.disease nervous system diseases respiratory tract diseases Clinical trial Obstructive sleep apnea Analgesics Opioid 030228 respiratory system Neurology Opioid Meta-analysis Observational study Neurology (clinical) business 030217 neurology & neurosurgery medicine.drug |
| Zdroj: | Sleep medicine reviews. 58 |
| ISSN: | 1532-2955 |
| Popis: | Summary We conducted a systematic review to address limited evidence suggesting that opioids may induce or aggravate obstructive sleep apnea (OSA). All clinical trials or observational studies on adults from 1946 to 2018 found through MEDLINE, EMBASE, CINAHL, PsycINFO, Cochrane Databases were eligible. We assessed the quality of the studies using published guidelines. Fifteen studies (six clinical trials and nine observational) with only two of good quality were included. Fourteen studies investigated the impact of opioids on the presence or severity of OSA, four addressed the effects of treatment for OSA in opioid users, and none explored the consequences of opioid use in individuals with OSA. Eight of 14 studies found no significant relationship between opioid use or dose and apnea-hypopnea index (AHI) or degree of nocturnal desaturation. A random-effects meta-analysis (n = 10) determined the pooled mean change in AHI associated with opioid use of 1.47/h (−2.63–5.57; I2 = 65%). Three of the four studies found that continuous positive airway pressure (CPAP) therapy reduced AHI by 17–30/h in opioid users with OSA. Bilevel therapy with a back-up rate and adaptive servo-ventilation (ASV) without mandatory pressure support successfully normalized AHI (≤5) in opioid users. Limited by a paucity of good-quality studies, our review did not show a significant relationship between opioid use and the severity of OSA. There was some evidence that CPAP, Bilevel therapy, and ASV alleviate OSA for opioid users, with higher failure rates observed in patients on CPAP in opioid users. |
| Databáze: | OpenAIRE |
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