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Apnea and Prescription Pain Meds - Beware
#1
Apnea and Prescription Pain Meds - Beware
I wanted to share a personal experience as a caution for anyone dealing with sleep apnea and using prescription pain medications, particularly opioids like morphine.

My sleep therapist (not my doctor) warned me about the risks of using opioids with untreated sleep apnea because these medications can reduce your breathing rate. However, once I received my BiPAP machine, I assumed I would be safe. It wasn’t until I started using OSCAR that I realized this wasn’t the case.

A few months ago, I was prescribed opioids for severe pain, and I noticed a significant difference in my sleep data.
In the first attachment, you’ll see a typical night of sleep without taking any opioids. My AHI for that night was 0.15, which is quite good..In the second attachment, where I took opioids throughout the night to manage pain, my AHI increased dramatically to 60.92.

This drastic difference is alarming and highlights how much opioids can affect your breathing—even with PAP therapy. After noticing this, I made the decision to stop taking opioids at night.
I hope this helps anyone considering opioid or other prescription pain meds.

- cyberfiche


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#2
RE: Apnea and Prescription Pain Meds - Beware
I'd like to get any feedback from other members who have seen changes in therapy when using medications. Let me know what you think about my experience above. Am I just crazy? Let me know what you've seen in your own data.

- cyberfiche
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#3
RE: Apnea and Prescription Pain Meds - Beware
Wow!  That is a huge difference.  I think your conclusion must be correct, that it's the medication causing the change.  I pray that you can find a medication that works but that does not interfere with your sleep.  Smile
Machine:  ResMed AirCurve 10 Vauto
Mask:  Bleep DreamPort Sleep Solution
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#4
RE: Apnea and Prescription Pain Meds - Beware
Not only for pain meds, but there is a recent FDA study that shows Gabapentin/Neurontin increase apnea events. It was ironic to see considering my sleep therapist prescribed it for better sleep...
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#5
RE: Apnea and Prescription Pain Meds - Beware
(09-28-2024, 04:21 PM)sleepyecho Wrote: Not only for pain meds, but there is a recent FDA study that shows Gabapentin/Neurontin increase apnea events. It was ironic to see considering my sleep therapist prescribed it for better sleep...

Oh wow. I had no idea about Gabapentin. Thanks for sharing that. My doctor has thought about prescribing that. I'll be sure to stay away from it. Thank goodness we have OSCAR so we can see what these meds are doing.
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#6
RE: Apnea and Prescription Pain Meds - Beware
Members with chronic needs for opioid pain relief need to use a machine with a backup rate, and preferably ASV. With the Vauto, you may be able to reduce CA events by changing to very-high trigger sensitivity, but the device still relies on spontaneous respiration. In that regard, it is no more protective of your respiration rate against central apnea than no treatment at all.
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#7
RE: Apnea and Prescription Pain Meds - Beware
After reading this post I questioned a mild muscle relaxer my VA Doc had me take twice a day. I cut out the evening dose, Dr approved, and my CPAP data improved with no other changes made. Good advice. Dr approval of course.
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#8
RE: Apnea and Prescription Pain Meds - Beware
A machine in auto mode where it has room to adjust the pressure to the extra pressure needed to overcome certain medicines relaxing effect on muscles should be able to give an acceptable AHI.

If i take opiates, bensodiazepines or drink alcohol my machine will need higher pressures to clear away apneas and hyponeas. And my AHI will increase either way since the machine reacts to events after the fact. But it is around 1 without meds and maybe 3-5 with meds.

In your case OP you might need to adjust the wiggle room for your machine. Best is of course if you can take smaller dose or none at all at night. But if you have severe pain you should know that you can likley get much better AHI by adjusting your machine settings. Maybe not as good as without meds but acceptable.
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#9
RE: Apnea and Prescription Pain Meds - Beware
(10-08-2024, 02:49 AM)40plus Wrote: In your case OP you might need to adjust the wiggle room for your machine. Best is of course if you can take smaller dose or none at all at night. But if you have severe pain you should know that you can likley get much better AHI by adjusting your machine settings. Maybe not as good as without meds but acceptable.

Thanks for the advice. I had not thought about going up on the pressure. I'll try that if I have to take opioids at night.

- cyberfiche
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