Opioid-based pain medications may cause sleep apnea, according to an article in the September issue of Pain Medicine, the journal of the American Academy of Pain Medicine.
“We found that sleep-disordered breathing was common when chronic pain patients took prescribed opioids,” explains lead author Lynn R. Webster, MD, from Lifetree Clinical Research and Pain Clinic in Salt Lake City, Utah. “We also found a direct dose-response relationship between central sleep apnea and methadone and benzodiazepines, an association which had not been previously reported.”
Opioids, effective medications for chronic pain treatment, are often used for cancer patients, but are now gaining widespread acceptance as long-term therapy for chronic pain unrelated to cancer. An increasing number of patients with nonmalignant chronic pain are receiving around-the-clock pain relief through opioid therapy.
The researchers studied sleep lab data on 140 patients taking around-the-clock opioid therapy for chronic pain to assess the potential and prevalence 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 investigators say that their results show a higher than expected prevalence of sleep disordered breathing in opioid treated chronic pain patients. Obstructive and central sleep apnea syndromes occurred in the studied population at a far greater rate (75%) than is observed in the general population, where obstructive sleep apnea is known to be underdiagnosed but has been estimated at roughly 2% to 4%. Central sleep apnea is estimated at 5% in people older than 65 years and from 1.5% to 5% in men less than 65 years old.
People who stop breathing during sleep because of faulty brain control have central sleep apnea as opposed to obstructive apnea, which is triggered by obesity and other health problems and accompanied by loud snoring.