SynthesisJournal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine2016
Medium Increased Risk for Central Sleep Apnea but Not Obstructive Sleep Apnea in Long-Term Opioid Users: A Systematic Review and Meta-Analysis.
Synthesis in Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
17 citing papers in PubMed, 47 citations in OpenAlex.
- Article
- Cardiorespiratory failure and sudden death induced by carfentanil exposure: Involvement of central mu1 opioid receptors.Toxicology and applied pharmacology · 2025Article
- Perioperative sleep disturbances in older adults: a scoping review of epidemiology and treatment.European geriatric medicine · 2025Article
- Association Between Gabapentinoid Use and Changes in Claims-Based Frailty Among Long-Term Opioid Users.Drugs & aging · 2025Article
- Article
- Cardiorespiratory failure induced by inhalation of aerosolized fentanyl in anesthetized rats.Respiratory physiology & neurobiology · 2024Article
- Baseline Characteristics From a New Longitudinal Cohort of Patients With Noncancer Pain and Chronic Opioid Use in the United States.The journal of pain · 2024Article
- A comparative examination of morphine and fentanyl: unravelling the differential impacts on breathing and airway stability.The Journal of physiology · 2023Article
- Past-year use or misuse of an opioid is associated with use of a sedative-hypnotic medication: a US National Survey on Drug Use and Health (NSDUH) study.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2022Article
- Less Well-Known Consequences of the Long-Term Use of Opioid Analgesics: A Comprehensive Literature Review.Drug design, development and therapy · 2022Review
- Daily associations between sleep and opioid use among adults with comorbid symptoms of insomnia and fibromyalgia.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2021Article
- Article
- Thoughts on the 2019 American Academy of Sleep Medicine position statement on chronic opioid therapy and sleep.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2020Article
- Medical Use of Long-term Extended-release Opioid Analgesics in Commercially Insured Adults in the United States.Pain medicine (Malden, Mass.) · 2020Article
- Treating restless legs syndrome in the context of sleep disordered breathing comorbidity.European respiratory review : an official journal of the European Respiratory Society · 2019Review
- Pain intensity as a moderator of the association between opioid use and insomnia symptoms among adults with chronic pain.Sleep medicine · 2018Article
- Effect of Opium Versus Methadone on Polysomnographic Characteristics of Patients With Obesity Hypoventilation Syndrome.Basic and clinical neuroscienceArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
STUDY
objectiveOpioids are associated with higher risk for ataxic breathing and sleep apnea. We conducted a systematic literature review and meta-analysis to assess the influence of long-term opioid use on the apnea-hypopnea and central apnea indices (AHI and CAI, respectively).
methodsA systematic review protocol (Cochrane Handbook guidelines) was developed for the search and analysis. We searched Embase, Medline, ACP Journal Club, and Cochrane Database up to November 2014 for three topics: (1) narcotics, (2) sleep apnea, and (3) apnea-hypopnea index. The outcome of interest was the variation in AHI and CAI in opioid users versus non-users. Two reviewers performed the data search and extraction, and disagreements were resolved by discussion. Results were combined by standardized mean difference using a random effect model, and heterogeneity was tested by χ(2) and presented as I(2) statistics.
resultsSeven studies met the inclusion criteria, for a total of 803 patients with obstructive sleep apnea (OSA). We compared 2 outcomes: AHI (320 opioid users and 483 non-users) and 790 patients with CAI (315 opioid users and 475 non-users). The absolute effect size for opioid use was a small increased in apnea measured by AHI = 0.25 (95% CI: 0.02-0.49) and a medium for CAI = 0.45 (95% CI: 0.27-0.63). Effect consistency across studies was calculated, showing moderate heterogeneity at I(2) = 59% and 29% for AHI and CAI, respectively.
conclusionsThe meta-analysis results suggest that long-term opioid use in OSA patients has a medium effect on central sleep apnea.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.