Safe use of opioids in individuals with obstructive sleep apnea

Obstructive sleep apnea (OSA) is a chronic breathing disorder that contributes to many other health problems (Epstein et al., 2009). It is present but undiagnosed in a large percentage of the population (Adesanya, Lee, Grilich, & Joshi, 2010). Pain is recognized as a public health problem in the United States, affecting millions of people of all ages (Committee on Advancing Pain Research, Care, and Education Board on Health Sciences Policy, 2011). Because of the high prevalence of both OSA and pain, it is very likely that an individual will have both conditions. Opioid analgesics used to treat pain may cause sedation and respiratory depression by themselves. When administered to individuals with OSA, the risk for harmful respiratory events increases. This article reviews the assessment and monitoring needed to administer opioids safely to individuals with OSA and identifies best practices from a review of the literature.