Sleep Disordered Breathing Caused by Chronic Opioid Use: Diverse Manifestations and Their Management

Abstract

Opioid-induced sleep disordered breathing presents a therapeutic predicament with the increasing incidence of prescription opioid use for noncancer chronic pain in the United States. Central sleep apnea with a Biot or cluster breathing pattern is characteristic of polysomnography studies; however, long-term clinical outcomes and the impact of therapy remain unknown. Novel ampakine-based therapies are being investigated. Randomized controlled trials with therapies that target the underlying pathophysiologic mechanisms of opioid-induced sleep disordered breathing are required.

Keywords: Ampakines; Ataxic breathing; Biot breathing; Central sleep apnea; Hypoglossal nerve; Obstructive sleep apnea; Positive airway pressure; Pre-Bötzinger complex.