Central sleep apnea induced by acute ingestion of opioids.
OBJECTIVE
Three cases are presented in which patients were using opioids as required for nonmalignant pain management and significant central sleep apnea developed. Patients in the first two cases had no evidence of sleep-related breathing disorders on polysomnography until they ingested an opioid for treatment of chronic pain during the night and severe central sleep apnea developed. The patient in our third case had established obstructive sleep apnea but experienced a significant number of central events after the ingestion of an opioid analgesic, leading to worsening severity of his underlying sleep-related breathing disorder.


CONCLUSIONS
The short-term ingestion of opioid analgesics can precipitate central sleep apnea in patients with chronic pain receiving long-term opiate therapy who otherwise show no evidence of central sleep apnea and have no cardiac or neurologic disease that would predispose them to central sleep apnea.
Department of Medicine, State University of New York at Buffalo, Buffalo, NY.
Mohammed
M
Mogri
Department of Medicine, State University of New York at Buffalo, Buffalo, NY.
Mohammed I A
MIA
Khan
Division of Pulmonary, Critical Care, and Sleep Medicine, State University of New York at Buffalo, Buffalo, NY.
Brydon J B
BJB
Grant
Division of Pulmonary, Critical Care, and Sleep Medicine, State University of New York at Buffalo, Buffalo, NY. Electronic address: mador@buffalo.edu.
M Jeffrey
MJ
Mador
D000328:Adult; D000701:Analgesics, Opioid / Q000009:adverse effects*; D002908:Chronic Disease; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000188:drug therapy*; D017286:Polysomnography; D020182:Sleep Apnea, Central / Q000139:chemically induced* / Q000503:physiopathology
D000701:Analgesics, Opioid