Opioids such as methadone are well known to cause central sleep apnea. Sleep Review Magazine reports a high rate of obstructive and central sleep apnea in patients who use opioids for chronic pain:
Sleep-disordered breathing is very common in patients who use opioids for chronic pain conditions, according to a report issued online September 6th by the journal Pain Medicine.
Of the 147 patients on chronic opioid therapy who agreed to undergo testing, 140 had data available for analysis, the report indicates.
"The biggest finding was an extraordinarily high prevalence of sleep-disordered breathing in opioid-treated chronic pain patients," Dr. Webster noted. "Obstructive and central sleep apnea syndromes occurred in the studied population at a far greater rate (75%) than is observed in the general population."
The most common type of sleep apnea, seen in 39% of all patients, was the obstructive type, followed by central sleep apnea in 24%, central and obstructive sleep apnea in 8%, and indeterminate type in 4%.
The apnea-hypopnea index was directly related to the daily dosage of methadone, but not to that of other opioids (p = 0.002). The central apnea index was directly linked to the daily dosage of both methadone (p = 0.008) and benzodiazepines (p = 0.004).
It is interesting that in this study methadone appeared to have a greater effect on sleep apnea than other opioids.
I run a suboxone clinic to treat persons addicted to opioids. I'll have to increase my monitoring of their sleep.