title: Chronic opioid use: a risk factor for central sleep apnoea and successful therapy with adaptive pressure support servo-ventilation.
abstract: Sleep apnoea is a global health problem with significant morbidity. Obesity is a well-known risk factor for this condition, however chronic intake of opioids as a risk factor for central sleep apnoea is under-recognised. We report a case of a 47-year-old man who developed significant sleep-disordered breathing secondary to opioid use for chronic pain. A sleep study demonstrated a picture of complex sleep apnoea with a prominent central sleep apnoea component. He had no significant improvement with conventional continuous positive airway pressure therapy. However, adaptive servo-ventilation had a dramatic effect on his symptoms and compliance. This case highlights the significant risk of central sleep apnoea with opioid use and illustrates the importance of adaptive servo-ventilation in the management of sleep-disordered breathing secondary to impaired central respiratory drive.
authors.affiliation: Department of Respiratory, Medicine, New Cross Hospital, Wolverhampton Road, Wolverhampton WV10 0QP, UK. ahmedfahim@doctors.org.uk
authors.forename: A
authors.initials: A
authors.lastname: Fahim
authors.forename: A O
authors.initials: AO
authors.lastname: Johnson
mesh_terms: D000701:Analgesics, Opioid / Q000008:administration & dosage / Q000009:adverse effects*; D059350:Chronic Pain / Q000188:drug therapy; D045422:Continuous Positive Airway Pressure; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications*; D012119:Respiration; D012121:Respiration, Artificial / Q000379:methods*; D012307:Risk Factors; D012890:Sleep; D020182:Sleep Apnea, Central / Q000209:etiology* / Q000628:therapy*; D012122:Ventilators, Mechanical
chemical_list: D000701:Analgesics, Opioid