[Long-term opioid therapy and respiratory insufficiency during sleep].
An increasing proportion of the patients with chronic pain are being treated with opioids on a long-term basis. There are indications that the causes of hypersomnia in patients under chronic opioid therapy are primarily related to breathing disorders during sleep. Hence, we compared the polysomnographies of three hypersomnic patients receiving long-term opioid therapy before and during nocturnal non-invasive ventilatory therapy. Significant findings were a central breathing pattern accompanied by reduced deep and REM sleep. On applying non-invasive ventilatory therapy, there was a significant improvement of respiratory status with an increase of deep sleep as well as a moderate decrease in hypersomnia. In patients under chronic opioid therapy with hypersomnia, the presence of central breathing disorders should be considered.
Nolte
J E S
JE
Klinik für Innere Medizin, SP Pneumologie, Intensiv- und Schlafmedizin, Philipps-Universität Marburg. johannesnolte@gmail.com
Dette
F
F
Cassel
W
W
Riese
C
C
Augsten
M
M
Koehler
U
U
D000328:Adult; D015360:Analgesia, Epidural; D002908:Chronic Disease; D045422:Continuous Positive Airway Pressure; D006970:Disorders of Excessive Somnolence / Q000139:chemically induced* / Q000209:etiology / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008134:Long-Term Care; D008297:Male; D008875:Middle Aged; D009020:Morphine / Q000008:administration & dosage* / Q000009:adverse effects*; D009294:Narcotics / Q000008:administration & dosage* / Q000009:adverse effects*; D010146:Pain / Q000188:drug therapy*; D011128:Polyradiculopathy / Q000188:drug therapy; D017286:Polysomnography; D017410:Practice Guidelines as Topic; D012131:Respiratory Insufficiency / Q000139:chemically induced* / Q000209:etiology / Q000503:physiopathology*; D012891:Sleep Apnea Syndromes / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology*; D020182:Sleep Apnea, Central / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy; D020181:Sleep Apnea, Obstructive / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy
D009294:Narcotics; D009020:Morphine