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Updated: Jun 30, 2026
07:54
Drug-Induced Sleep Endoscopy (DISE) with Target Controlled Infusion (TCI) and Bispectral Analysis in Obstructive Sleep Apnea
Published on: December 6, 2016
Opioid-associated central sleep apnea: a case series.
1University of Maryland School of Medicine, Baltimore, 21201-1192, USA.
Sleep & Breathing = Schlaf & Atmung
|September 23, 2008
Summary
Opioid-induced central sleep apnea (CSA) in chronic pain patients can be treated with bilevel ventilation (BLV). This treatment improved sleep quality and reduced hypoxemia in a small patient group.
Area of Science:
- Sleep Medicine
- Pulmonology
- Pain Management
Background:
- Opioid use for chronic pain is common, but associated respiratory complications like central sleep apnea (CSA) are underreported.
- While CSA is known in patients on methadone maintenance, data on opioid-induced CSA in chronic pain populations is scarce.
Observation:
- Six patients on long-term opioids for chronic pain presented with excessive daytime sleepiness and diagnosed central sleep apnea (apnea-hypopnea index >5/hr with >50% central events).
- Patients exhibited significant nocturnal hypoxemia (time <90% O2 saturation 1.8 min to 6.4 h).
Findings:
- Four patients received chronic bilevel ventilation (BLV) treatment (IPAP 12-16 cm H2O/EPAP 4-8 cm H2O with backup rate 12-16).
- Following at least 6 months of BLV therapy, Epworth sleepiness scores improved significantly in all treated patients.
Implications:
- Bilevel ventilation (BLV) effectively addresses nocturnal hypoxemia and sleep fragmentation in patients with opioid-induced central sleep apnea.
- Further randomized controlled trials are warranted to objectively assess the impact of BLV on daytime function in this patient population.
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