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Selected Report |

Central Sleep Apnea Induced by Acute Ingestion of Opioids*

Mohammed Mogri, MD; Mohammed I. A. Khan, MD; Brydon J. B. Grant, MD, FCCP; M. Jeffrey Mador, MD
Author and Funding Information

*From the Department of Medicine (Drs. Mogri and Khan), and the Division of Pulmonary, Critical Care, and Sleep Medicine (Drs. Grant and Mador), State University of New York at Buffalo, Buffalo, NY.

Correspondence to: M. Jeffrey Mador, MD, Division of Pulmonary, Critical Care and Sleep Medicine, Section 111S, 3495 Bailey Ave, Buffalo, NY 14215; e-mail: mador@buffalo.edu



Chest. 2008;133(6):1484-1488. doi:10.1378/chest.07-1891
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Objectives: Three cases are presented in which patients were using opioids as required for nonmalignant pain management and significant central sleep apnea developed. Patients in the first two cases had no evidence of sleep-related breathing disorders on polysomnography until they ingested an opioid for treatment of chronic pain during the night and severe central sleep apnea developed. The patient in our third case had established obstructive sleep apnea but experienced a significant number of central events after the ingestion of an opioid analgesic, leading to worsening severity of his underlying sleep-related breathing disorder.

Conclusion: The short-term ingestion of opioid analgesics can precipitate central sleep apnea in patients with chronic pain receiving long-term opiate therapy who otherwise show no evidence of central sleep apnea and have no cardiac or neurologic disease that would predispose them to central sleep apnea.

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