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Long-term opioid use negatively affects sleep, health, experts warn

A position statement from the American Academy of Sleep Medicine highlights studies linking use of pain medication to sleep apnea and other disorders.

By Brian Dunleavy
Long-term prescription opioid use may disrupt sleep, according to a statement released by American Academy of Sleep Medicine. File photo by Wokandapix/Pixabay
Long-term prescription opioid use may disrupt sleep, according to a statement released by American Academy of Sleep Medicine. File photo by Wokandapix/Pixabay

Nov. 20 (UPI) -- Long-term use of prescription opioids may cause those who rely on them for pain relief to lose sleep -- literally.

In a position statement released Tuesday, and published in the Journal of Clinical Sleep Medicine, the American Academy of Sleep Medicine noted that recent research suggests that use of the pain drugs, which are addictive, may reduce sleep quality by impacting rapid-eye movement, or REM, sleep and increasing risk for conditions like obstructive sleep apnea.

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An estimated 92 million Americans are currently using prescription opioids, according to analysis published in September 2017 in the journal Annals of Internal Medicine.

In addition to legitimate use of prescription opioids to treat chronic pain conditions, about 11.5 million people in the U.S. are estimated to be misusing or abusing opioid drugs illegally.

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"This statement increases awareness among healthcare providers of the important adverse events that can occur in patients on chronic opioid therapy," co-author R. Nisha Aurora, associate professor at Rutgers Robert Wood Johnson Medical School in New Jersey, said in a statement. "The paper also highlights the need for providers to recognize and diagnose sleep-related breathing disorders that are frequently seen with chronic opioid use."

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The paper highlights that chronic opioid use is associated with changes in sleep architecture -- or the characteristics of normal sleep -- and an increased risk of respiratory depression, or breathing problems, during sleep.

Sleep-related respiratory conditions like obstructive sleep apnea have been linked with serious health complications, including heart disease and stroke.

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The authors of the AASM position statement cite studies showing that long-term opioid therapy has the potential to further disrupt sleep by reducing sleep efficiency, slow wave sleep, and affect REM sleep. Another adverse effect of opioid use is respiratory depression, which can increase the risk of sleep-related breathing disorders such as sleep-related hypoventilation, central sleep apnea and obstructive sleep apnea.

If left untreated, they said, sleep-related breathing disorders can be harmful to a patient's health. However, they can be diagnosed by a medical provider following an overnight sleep study in a specialized sleep center. Effective treatments are also available.

Medical providers who care for patients on chronic opioid therapy -- as well as the opioid users themselves -- need to be aware of the signs of disrupted sleep, such as snoring and excessive daytime sleepiness, in order to provide their patients with high quality care.

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"Because of the complex relationship between pain, sleep, daytime functioning, and opioid therapy, a strong collaboration between pain specialists, sleep physicians, and primary care providers is needed to optimize patient benefit and minimize complications when opioids are part of chronic therapy," said Aurora, who is currently collaborating with the Brain Health Institute at Rutgers to study sleep in those seeking therapy for opioid addiction.

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