Patients with chronic pain often complain of sleep problems, ranging from insomnia to broken sleep patterns. Sleep disturbances have been shown to make chronic pain worse, as well as add to the frustration level of the patient. According to several studies published, opioid-based pain medications, which are often used for chronic pain relief, may cause sleep apnea, creating a catch 22 scenario for many patients.
“We found that sleep-disordered breathing was common when chronic pain patients took prescribed opioids,” explains lead author of a study published in Pain Medicine, the journal of the American Academy of Pain Medicine, Lynn R. Webster, MD, from Lifetree Clinical Research and Pain Clinic in Salt Lake City, Utah. “We also found a direct dose-response relationship between central sleep apnea and methadone and benzodiazepines, an association which had not been previously reported.”
The researchers studied the sleep lab data of 140 patients taking around-the-clock opioid therapy for chronic pain. All patients were on the opioid therapy for at least six months, with a stable dose for a minimum of six weeks.
Sleep apnea symptoms were found in 75 percent of those taking opioids, a number that is simply too large to ignore. Unlike obstructive sleep apnea, caused by soft tissue blockage in the back of the throat, the patients suffered from symptoms that are more likely directly related to the part of the brain that controls respiration, which could lead to a higher morbidity risk.
Ramie Tritt, MD, President, Atlanta ENT