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Severe central sleep apnoea associated with nalmefene: a case report
Charles Khouri1,2,3, François Arbib4, Bruno Revol1,3
1Pharmacovigilance Unit, Grenoble Alps University Hospital, Grenoble, France.
British Journal of Clinical Pharmacology
|February 27, 2018
Summary
Nalmefene, an opioid antagonist for alcohol dependence, may cause central sleep apnoea (CSA). This condition resolved after discontinuing nalmefene treatment, suggesting a link between the drug and CSA.
Area of Science:
- Pharmacology
- Sleep Medicine
- Neurology
Background:
- Nalmefene is an opioid antagonist approved for alcohol dependence treatment.
- Opioid receptors play a role in respiratory regulation during sleep.
Observation:
- A 52-year-old woman developed severe central sleep apnoea (CSA) 5 months after starting nalmefene.
- Sleep studies revealed a high apnoea-hypopnoea index predominantly of central events.
Findings:
- Discontinuation of nalmefene led to the complete resolution of CSA.
- The pathophysiology of nalmefene-induced CSA is unclear but may involve kappa-opioid receptors.
Implications:
- Clinicians should monitor patients treated with nalmefene for potential development of CSA.
- Further research is needed to elucidate the mechanism, prevalence, and management of CSA associated with nalmefene and other alcohol disorder therapies.
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