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J R Coll Physicians Edinb. 2012;42(4):314-6. doi: 10.4997/JRCPE.2012.407.

Chronic opioid use: a risk factor for central sleep apnoea and successful therapy with adaptive pressure support servo-ventilation.

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Department of Respiratory, Medicine, New Cross Hospital, Wolverhampton Road, Wolverhampton WV10 0QP, UK.


Sleep apnoea is a global health problem with significant morbidity. Obesity is a well-known risk factor for this condition, however chronic intake of opioids as a risk factor for central sleep apnoea is under-recognised. We report a case of a 47-year-old man who developed significant sleep-disordered breathing secondary to opioid use for chronic pain. A sleep study demonstrated a picture of complex sleep apnoea with a prominent central sleep apnoea component. He had no significant improvement with conventional continuous positive airway pressure therapy. However, adaptive servo-ventilation had a dramatic effect on his symptoms and compliance. This case highlights the significant risk of central sleep apnoea with opioid use and illustrates the importance of adaptive servo-ventilation in the management of sleep-disordered breathing secondary to impaired central respiratory drive.

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