慢性疼痛与睡眠呼吸暂停的严重程度有关,但在使用阿片类药物的人中,间歇性低氧化症会减弱
Jeremy E Orr1, Naa-Oye Bosompra1, Brynn Norby1
1Division of Pulmonary, Critical Care, and Sleep Medicine, UC San Diego, San Diego, CA, United States.
Pain
|July 24, 2025
概括
长期使用阿片类药物治疗慢性疼痛与睡眠呼吸障碍 (SDB) 有关,这可能会加剧疼痛. 然而,严重的低氧化症可能会减轻这种疼痛关联,表明复杂的相互作用.
科学领域:
- 睡眠医学 睡眠医学
- 疼痛管理 疼痛管理
- 肺部病理学 肺部病理学
背景情况:
- 长期的阿片类药物治疗慢性疼痛是常见的,但通常与不受控制的症状和阿片类药物危机有关.
- 阿片类药物可以诱导睡眠呼吸障碍 (SDB),可能造成睡眠不良加剧疼痛并推动进一步使用阿片类药物的循环.
研究的目的:
- 调查睡眠呼吸障碍 (SDB) 和长期使用阿片类药物治疗非癌症疼痛的成年人疼痛之间的关系.
- 探索缺氧负担如何影响SDB严重程度和疼痛结果之间的关联.
主要方法:
- 招募成年人每天使用阿片类药物>3个月用于非癌症疼痛.
- 通过问卷评估疼痛和睡眠,通过冷压力测试评估疼痛耐受性和多睡眠学.
- 来自多睡眠学数据的量化缺氧负担.
主要成果:
- 观察到SDB的高患病率,其中78%的呼吸暂停-呼吸暂停指数 (AHI) >5/小时.
- 增加的AHI与恶化的疼痛干扰得分和疼痛耐受性降低相关.
- AHI与疼痛之间的关联因较高的低氧负担而减弱,表明存在复杂的相互作用.
结论:
- 睡眠呼吸障碍很普遍,并且与慢性阿片类药物使用者的疼痛恶化有关.
- 低氧症起到缓解作用,表明SDB对疼痛的影响不均,取决于氧气脱度水平.
- 需要进一步的研究,包括干预研究,以澄清 SDB 在这个人群中治疗 SDB 的机制和潜在益处.
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