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In reply: Opioid therapy and sleep apnea (June 2016)

Marissa C. Galicia-Castillo, MD
Cleveland Clinic Journal of Medicine February 2017, 84 (2) 94; DOI: https://doi.org/10.3949/ccjm.84c.02002

Dr. Geller makes some excellent points about sleep and opioid use.

Opioids pose risks,1 just like any other type of medication. In particular, opioids have been linked to sleep-disordered breathing, which affects 70% to 85% of patients taking opioids.2–4

Other options can be used in some older adults, but they are not always successful. Ideally, nonpharmacologic strategies and nonopioid medications such as acetaminophen, nonsteroidal anti-inflammatory agents, antidepressants, and anticonvulsants should be used, although these medications have their own side effects. Optimum pain control may offer the potential for significant improvement in function, and opioids are but one tool in the clinician’s kit.

Ongoing discussions of the risks and benefits are necessary, along with continuous re-evaluation of the need for and effect of opioids.

REFERENCES

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    1. Jungquist CR,
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    1. Webster LR,
    2. Choi Y,
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    5. Grant BJ
    . Sleep-disordered breathing and chronic opioid therapy. Pain Med 2008; 9:425–432.
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    1. Mogri M,
    2. Khan MI,
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    4. Mador MJ
    . Central sleep apnea induced by acute ingestion of opioid. Chest 2008; 133:1484–1488.
    OpenUrlCrossRefPubMed
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