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Opioid Therapy and Sleep Disorders: Risks and Mitigation Strategies
Martin D Cheatle1, Lynn R Webster2
1Center for Studies of Addiction, Perelman School of Medicine, University Pennsylvania, Philadelphia, Pennsylvania, USA.
Pain Medicine (Malden, Mass.)
|October 14, 2015
Summary
Opioids have conflicting effects on sleep quality, but strongly link to sleep disordered breathing (SDB). Routine SDB assessment is crucial for patients on chronic opioid therapy (COT).
Area of Science:
- Pharmacology
- Sleep Medicine
- Pain Management
Background:
- Chronic pain often co-occurs with sleep disorders.
- The impact of opioids on sleep quality remains controversial.
- Concerns exist regarding chronic opioid therapy (COT), sleep disordered breathing (SDB), and overdose risk.
Purpose of the Study:
- To review the literature on opioid effects on sleep disorders.
- To discuss risk assessment and mitigation strategies for patients on COT.
Main Methods:
- Narrative review of current literature.
- Focused on prescription opioids, sleep quality, and SDB risk factors in chronic pain patients.
Main Results:
- Conflicting evidence on opioid effects on sleep quality, duration, and efficiency.
- Strong evidence links opioids to SDB, with risk factors including methadone, high doses (>200 mg MED), and benzodiazepine co-administration.
- Opioids may cause sleep disturbance and hyperalgesia.
Conclusions:
- Further research is needed on opioid effects on sleep and pain.
- Routine assessment for SDB in patients on COT is recommended.
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