All articles tagged Narcotics

The Association of Obstructive Sleep Apnea and Chronic Pain

Christopher J. Lettieri, MD

May 24, 2013

Effect of Narcotics on Respiratory Physiology

Narcotics, and in particular opioids, have several effects on respiratory physiology, which are more pronounced during sleep. They decrease central respiratory patterns, respiratory rate, and tidal volume. They also increase airway resistance and decrease the patency of the upper airways. This may lead to ineffective ventilation and upper airway obstruction in susceptible individuals.

These agents can produce irregularities in normal breathing patterns. Irregular respiratory pauses and gasping may lead to erratic breathing and significant variability in respiratory rate and effort. This ataxic, or Biot breathing, is observed in the majority of patient with long-term opiate use.[10]

Narcotic Use and Sleep-Disordered Breathing

The incidence of sleep-disordered breathing after both short- and long-term opioid use is well established, but also somewhat controversial. Several studies have shown a marked increase in sleep-disordered breathing with both acute and chronic use of narcotics, regardless of the agent used, dose, duration of therapy, or individual risk factors for OSA.

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