ArticleJournal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine2014
Adaptive servoventilation for treatment of opioid-associated central sleep apnea.
Article in Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers, 2 of them syntheses that pooled it.
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Who cites it
31 citing papers in PubMed, 2 syntheses or guidelines pooled it, 95 citations in OpenAlex.
- Prevalence of sleep-disordered breathing in opioid users with chronic pain: a systematic review and meta-analysis.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2020Pooled it
- Medium Increased Risk for Central Sleep Apnea but Not Obstructive Sleep Apnea in Long-Term Opioid Users: A Systematic Review and Meta-Analysis.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2016Pooled it
- Continuous Positive Airway Pressure Mitigates Opioid-induced Worsening of Sleep-disordered Breathing Early after Bariatric Surgery.Anesthesiology · 2016Trial
- Update on the Pathophysiology, Aetiology and Management of Central Sleep Apnoea.Respirology (Carlton, Vic.) · 2026Review
- Sleep-Related Breathing Disorders: A Comprehensive Review of Surgical Innovations and Evolving Technologies.Healthcare (Basel, Switzerland) · 2026Review
- Obstructive Sleep Apnea and Cardiovascular Disease: Mechanisms, Diagnostics, and Emerging Therapeutic Approaches.Biomedicines · 2026Review
- Research priorities to improve classification of sleep-wake disorders.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2026Review
- Opioids and Respiratory Related Consequences.Sleep medicine clinics · 2025Review
- Treatment of sleep-disordered breathing in opioid users with adaptive servo-ventilation: a subgroup analysis of the European READ-ASV registry.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2025Article
- Article
- International Consensus Statement on Obstructive Sleep Apnea.International forum of allergy & rhinology · 2023Review
- Experience With Adaptive Servo-Ventilation Among Veterans in the Post-SERVE-HF Era.Federal practitioner : for the health care professionals of the VA, DoD, and PHS · 2023Article
- Distinguishing central from obstructive hypopneas on a clinical polysomnogram.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2023Article
- Review
- ERS International Congress 2022: highlights from the Sleep Disordered Breathing Assembly.ERJ open research · 2023Article
- Phrenic nerve stimulation for treatment of central sleep apnea.Frontiers in sleep · 2023Review
- Opioid Use Disorder, Sleep Deficiency, and Ventilatory Control: Bidirectional Mechanisms and Therapeutic Targets.American journal of respiratory and critical care medicine · 2022Article
- The Pathogenesis of Central and Complex Sleep Apnea.Current neurology and neuroscience reports · 2022Review
- Sleep Deficiency and Opioid Use Disorder: Trajectory, Mechanisms, and Interventions.Clinics in chest medicine · 2022Review
- Sleep-Related Breathing Disorders: When CPAP Is Not Enough.Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics · 2021Review
Corrections and comments
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Authors and funding
4 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
rationaleOpioids have become part of contemporary treatment in the management of chronic pain. Although severe daytime ventilatory depression is uncommon, chronic use of opioids could be associated with severe central and obstructive sleep apnea.
objectivesTo determine the acute efficacy, and prolonged use of adaptive servoventilation (ASV) to treat central sleep apnea in patients on chronic opioids.
methodsTwenty patients on opioid therapy referred for evaluation of obstructive sleep apnea (OSA) were found to have central sleep apnea (CSA). The first 16 patients underwent continuous positive airway pressure (CPAP) titration, which showed persistent CSA. With the notion that CSA will be eliminated with continued use of CPAP, 4 weeks later, 9 of the 16 patients underwent a second CPAP titration which proved equally ineffective. Therefore, therapy with CPAP was abandoned. All patients underwent ASV titration. MAIN
resultsDiagnostic polysomnography showed an average apnea-hypopnea index (AHI) of 61/h and a central-apnea index (CAI) of 32/h. On CPAP 1, AHI was 34/h and CAI was 20/h. Respective indices on CPAP 2 were AHI 33/h and CAI 19/h. During titration with ASV, CAI was 0/h and the average HI was 11/h on final pressures. With a reduction in AHI, oxyhemoglobin saturation nadir increased from 83% to 90%, and arousal index decreased from 29/h of sleep to 12/h on final ASV pressures. Seventeen patients were followed for a minimum of 9 months and up to 6 years. The mean long-term adherence was 5.1 ± 2.5 hours.
conclusionsChronic use of opioids could be associated with severe CSA which remains resistant to CPAP therapy. ASV device is effective in the treatment of CSA and over the long run, most patients remain compliant with the device. Randomized long-term studies are necessary to determine if treatment of sleep apnea with ASV improves quality of life and the known mortality associated with opioids.
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