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Concomitant benzodiazepine and opioids decrease sleep apnoea risk in chronic pain patients.

Soodaba Mir1, Jean Wong1,2, Clodagh M Ryan3

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|September 1, 2020
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Summary
This summary is machine-generated.

Concurrent use of sedating drugs and opioids in chronic pain patients was studied. Benzodiazepines with opioids reduced sleep apnoea risk and severity by increasing arousal thresholds, despite mild respiratory depression.

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Area of Science:

  • Sleep Medicine
  • Pharmacology
  • Pain Management

Background:

  • Chronic pain patients often use sedating drugs and opioids concurrently.
  • Concerns exist regarding respiratory impacts during sleep with these combinations.
  • The effect on sleep apnoea is not well understood.

Purpose of the Study:

  • To assess the impact of concomitant sedating drugs and opioids on sleep apnoea prevalence and severity.
  • To investigate the relationship between drug combinations and sleep-disordered breathing in pain patients.

Main Methods:

  • Prospective cohort study at five chronic pain clinics.
  • In-laboratory polysomnography performed on participants.
  • Participants categorized into "centrally acting drugs and opioid users" versus "sole opioid users".

Main Results:

  • Sleep apnoea was present in 58.8% of participants (n=204).
  • Benzodiazepine/opioid users showed a 69% decreased odds of sleep apnoea compared to sole opioid users (OR 0.31).
  • Concomitant use was linked to lower respiratory arousal index and slightly reduced overnight oxygen saturation.

Conclusions:

  • In chronic pain patients on opioids, benzodiazepines paradoxically reduced sleep apnoea risk.
  • This reduction is attributed to an increased respiratory arousal threshold.
  • Mild respiratory depression occurred but did not negate the benefit on sleep apnoea.