title: Reversal of sleep-disordered breathing with opioid withdrawal.
abstract: Obstructive sleep apnea, central sleep apnea, sleep related hypoventilation, Biot's or ataxic breathing, and cluster breathing are some of the commonly described sleep disorders in patients who are on long-term opioids. Continuous positive airway pressure that is commonly used to treat obstructive sleep apnea may not be effective in treating sleep-disordered breathing in long-term opioid users, and an adaptive servoventilator (ASV) may be needed. We present a 30-year-old woman with excessive daytime sleepiness and sleep-disordered breathing for the past 4 years. Medical history was complicated by chronic osteomyelitis, periorbital abscess, and chronic facial pain requiring methadone for pain control for the last 4 years. In this case, ASV, though effective, was not tolerable due to chronic facial pain, and successful withdrawal of methadone at our pain rehabilitation center resolved the sleep-disordered breathing and improved daytime sleepiness. This is to our knowledge the first case report of resolution of sleep-disordered breathing and improvement in daytime sleepiness after withdrawal of long-term opioid use.
authors: Mayo Clinic--Divison of Pulmonary, Sleep and Critical Care Medicine, Rochester, Minnesota 55901, USA. ramar.kannan@mayo.edu
authors: Kannan
authors: K
authors: Ramar
mesh_terms: D000328:Adult; D000701:Analgesics, Opioid / Q000009:adverse effects*; D045422:Continuous Positive Airway Pressure; D004562:Electrocardiography; D004569:Electroencephalography / Q000379:methods; D004576:Electromyography / Q000379:methods; D005260:Female; D006801:Humans; D008691:Methadone / Q000009:adverse effects*; D017286:Polysomnography / Q000379:methods; D012891:Sleep Apnea Syndromes / Q000191:economics*; D013375:Substance Withdrawal Syndrome / Q000150:complications*
chemical_list: D000701:Analgesics, Opioid; D008691:Methadone