According to an article in Pain Medicine, the journal of the American Academy of Pain Medicine, patients who use opioid-based pain medications have an increased risk of developing sleep apnea. In a recent study, three-fourths of the patients on chronic opioid therapy had some degree of sleep apnea. The study also revealed a direct dose-response relationship between central sleep apnea and methadone used with benzodiazepines.
The research, conducted at the Lifetree Clinical Research and Pain Clinic in Salt Lake City, Utah, studied sleep lab data on 140 patients taking around-the-clock opioid therapy for chronic pain to assess the potential and prevalence of sleep apnea in opioid-treated pain patients. All patients were on opioid therapy for at least six months with stable dosing for at least four weeks. The results showed that 75 percent of the studied population had some form of sleep apnea, which is significantly higher than the estimated two to four percent found in the general population.
Authors of the study noted that if opioid medications increase sleep apnea risk as their research suggests, then chronic pain patients who are prescribed opioids have a higher risk of morbidity and mortality. In a press release, Dr. Lynn R. Webster, lead author of the study, said, “The challenge is to monitor and adjust medications for maximum safety, not to eliminate them at the expense of pain management.”
This research may help shed some light on the increase in deaths due to accidental overdose linked to opioid use – particularly methadone. Apparently the mix of methadone and benzodiazepines can cause respiratory depression. Until more studies are done to better understand the mechanisms involved and identify those at risk, doctors and patients will have to weigh the potential risks of opioid treatment against the potential for an improved quality of life. And it would stand t reason that anyone currently taking opioid medications on a regular basis should seriously consider being tested for sleep apnea.
Note: There are two types of sleep apnea: obstructive sleep apnea and central sleep apnea. Most people are more familiar with obstructive sleep apnea, which can be triggered by obesity and other health problems and is accompanied by loud snoring. With central sleep apnea, breathing stops due to a malfunction of the part of the brain that controls respiration. There are currently no known indicators of central sleep apnea. Both types of sleep apnea were observed in the study.
Published On: October 31, 2007