"please keep me updated about oximeters "
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Help understanding sleep study
I'm a Veteran and have been getting all my health care from the VA for the last 1.5 years. I have chronic pain and have been treated with opioids (Morphine and Oxycodone) since 2006. Last summer, I told the Nurse Practitioner I've been seeing at the Mental Health Clinic that I haven't been sleeping well. I figured on account of the pain and I've never been a good sleeper most of my life. She asked if I wanted to go for a sleep study, so I agreed.
The sleep study, performed 10/17/2012, came back indicating that I had:
Severe obstructive sleep apnea (327.23) with mild associated hypoxia.
Mild underlying central sleep apnea (327.29) with worsening demonstrated while on PAP therapy
Inability to correct sleep related breathing disorder on CPAP due to significant appearance of events while on CPAP and Bilevel therapy.
This is some of the information from the report. I've attached the report in the event someone would like to read it. There'd be too much too type here.
Baseline Central Apnea Index 3.3 AHI 51.7 (unassisted)
5/5/0 Central Apnea Index 60 AHI 4.5 (CPAP)
9/7/0 Central Apnea Index 78.6 AHI 0.0 (CPAP)
0/0/2 O2LPM Central Apnea Index 6.5 AHI 1.2 (Oxygen)
I had no idea I had sleep apnea. No one has explained the report to me. They are blaming my apnea on my opioid pain meds, which at the time of the study, I was taking 45mg - 30mg of Morphine SR x 3 and 5mg Oxycodone x 4. They believe that taking these meds away will solve the problem.
This is what the doctor from the sleep clinic wrote to my pain management doctor:
"He did his best with oxygen alone (at the time of the study, CPAP was not effective). This may have been attributable to his medications at the time (opioids). If he has successfully, weaned off the opioid medications, and remains symptomatic, I would repeat the sleep study (can be done with portable home T3 study). This study should be done without supplemental oxygen to determine whether or not he continues to have significant respiratory events (off medications). If so, CPAP might then be helpful, if not he may be able to eliminate the need for interventions."
Would taking the opioids cause me to have apnea? No one has discussed the sleep study report with me, so I don't know how serious this is. Is it serious? I know that the study was done 10/17/2012 and the report came out 11/8/2012 and my pain management doctor is just now having me wean off my opioid pain meds. This is making my life miserable. Ironically, I received a letter a couple of days a ago notifying me of an appointment 03/05/2013 to pickup a home oxygen machine to use while weaning off my opioids. I will already be off of them by then. The VA is so slow.
I have year round allergies and my nose is always stuffed up to some extent. Would that have an effect on the apnea.
Thanks
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Sleep Study 2.PDF, 1.1 MB
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Replies to This Discussion
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Permalink Reply by Mary Z on
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I googled "can opiates cause sleep apnea?". I found a lot of websites that say yes, opiates can cause central sleep apnea in some people. However none of these articles were from reputable medical sources. Adaptive servo ventilation (ASV) is currently the treatment of choice for complex or mixed sleep apnea and central sleep apnea. I'm glad I go to a private pain management center which does not try to wean you off medication unless you request that.
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Permalink Reply by RockRpsgt on
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Yes, opiates can and will cause central sleep apnea(CSA). Significant improvement was seen on O2 alone. I see this quite a bit in my own experiences.
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Permalink Reply by Scott McIntosh on
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I didn't have central sleep apnea until they used a CPAP machine on me. Unassisted, I have severe OSA. I am paying a BIG price by giving up the opioids, my doctors choice, not mine, because my pain level now ranges from 7 - 9. I try to move as little as possible. I wish there had been some compromise.
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Rock, you explained to me the difference between respiratory depression and apnea one time- do you think you can go into it a bit more. Also does respiratory depression look like or cause central apnea? It's good to see you!
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It's good to see you as well. Apnea is caused by loss of muscle tone pure and simple. This in itself causes respiratory supression by limiting the amount of oxygen allowed into the system. Medicinal induced supression is somewhat different. This type of supression is caused by certain types of meds like those made from opiates. These slow down the drive to breathe by changing the way the gas exchange works in our system. These types of events will typically show up as periodic breathing, centrals, or even increase the severity of obstructive apnea.
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