Prevalence of sleep-disordered breathing in opioid users with chronic pain: a systematic review and meta-analysis.

Analgesics, Opioid / therapeutic use Chronic Pain / drug therapy Humans Prevalence Sleep Apnea Syndromes / epidemiology Sleep Apnea, Central
opioids prevalence sleep-disordered breathing

Journal

Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine
ISSN: 1550-9397
Titre abrégé: J Clin Sleep Med
Pays: United States
ID NLM: 101231977

Informations de publication

Date de publication:
15 06 2020
Historique:
pubmed: 28 2 2020
medline: 24 6 2021
entrez: 28 2 2020
Statut: ppublish

Résumé

Opioids have been reported to increase the risk for sleep-disordered breathing (SDB) in patients with noncancer chronic pain on opioid therapy. This study aims to determine the pooled prevalence of SDB in opioid users with chronic pain and compare it with patients with pain:no opioids and no pain:no opioids. A literature search of PubMed, Medline, Embase, and Cochrane Central Register of Controlled Trials was conducted. We included all observational studies that reported the prevalence of SDB in patients with chronic pain on long-term opioid therapy (≥3 months). The primary outcome was the pooled prevalence of SDB in opioid users with chronic pain (pain:opioids group) and a comparison with pain:no opioids and no pain:no opioids groups. The meta-analysis was performed using a random-effects model. After screening 1,404 studies, 9 studies with 3,791 patients were included in the meta-analysis (pain:opioids group, n = 3181 [84%]; pain:no opioids group, n = 359 [9.4%]; no pain:no opioids group, n = 251 [6.6%]). The pooled prevalence of SDB in the pain:opioids, pain:no opioids, and no pain:no opioids groups were 91%, 83%, and 72% in sleep clinics and 63%, 10%, and 75% in pain clinics, respectively. Furthermore, in the pain: opioids group, central sleep apnea prevalence in sleep and pain clinics was 33% and 20%, respectively. The pooled prevalence of SDB in patients with chronic pain on opioid therapy is not significantly different compared with pain:no opioids and no pain:no opioids groups and varies considerably depending on the site of patient recruitment (ie, sleep vs pain clinics). The prevalence of central sleep apnea is high in sleep and pain clinics in the pain:opioids group. Clinical Trial Registration: Registry: PROSPERO: International prospective register of systematic reviews; Name: Prevalence of sleep disordered breathing, hypoxemia and hypercapnia in patients on oral opioid therapy for chronic pain management; URL: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42018103298; Identifier: CRD42018103298.

Identifiants

DOI: 10.5664/jcsm.8392 PMID: 32105208 PMC: PMC7849655
pubmed: 32105208
doi: 10.5664/jcsm.8392
pmc: PMC7849655
doi:

Substances chimiques

Analgesics, Opioid 0

Types de publication

Journal Article Meta-Analysis Research Support, Non-U.S. Gov't Systematic Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

961-969

Commentaires et corrections

Type : CommentIn

Informations de copyright

© 2020 American Academy of Sleep Medicine.

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Auteurs

Talha Mubashir (T)

Department of Anesthesia and Pain Medicine, University Health Network, University of Toronto, Toronto, Ontario, Canada.

Mahesh Nagappa (M)

Department of Anesthesia and Perioperative Medicine, London Health Sciences Centre and St. Joseph Health Care, Western University, London, Ontario, Canada.

Nilufar Esfahanian (N)

Department of Anesthesia and Pain Medicine, University Health Network, University of Toronto, Toronto, Ontario, Canada.

Joseph Botros (J)

Department of Anesthesia and Pain Medicine, University Health Network, University of Toronto, Toronto, Ontario, Canada.

Abdul A Arif (AA)

Department of Anesthesia and Pain Medicine, University Health Network, University of Toronto, Toronto, Ontario, Canada.

Colin Suen (C)

Department of Anesthesia and Pain Medicine, University Health Network, University of Toronto, Toronto, Ontario, Canada.

Jean Wong (J)

Department of Anesthesia and Pain Medicine, University Health Network, University of Toronto, Toronto, Ontario, Canada.
Department of Anesthesia and Pain Medicine, Women's College Hospital, University of Toronto, Toronto, Ontario, Canada.

Clodagh M Ryan (CM)

Centre of Sleep Health and Research, Department of Medicine, University Health Network, University of Toronto, Toronto, Ontario, Canada.

Frances Chung (F)

Department of Anesthesia and Pain Medicine, University Health Network, University of Toronto, Toronto, Ontario, Canada.

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Classifications MeSH

questionsmedicales.fr › Actions chimiques et utilisations › Actions pharmacologiques › Utilisations thérapeutiques › Agents du système nerveux central › Dépresseurs du système nerveux central › Stupéfiants › Analgésiques morphiniques › Prevalence of sleep-disordered breathing in...
questionsmedicales.fr › États, signes et symptômes pathologiques › Signes et symptômes › Manifestations neurologiques › Douleur chronique › Prevalence of sleep-disordered breathing in...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Prevalence of sleep-disordered breathing in...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Collecte de données › Registre civil › Morbidité › Prévalence › Prevalence of sleep-disordered breathing in...
questionsmedicales.fr › Maladies du système nerveux › Syndromes d'apnées du sommeil › Prevalence of sleep-disordered breathing in...
questionsmedicales.fr › Maladies du système nerveux › Syndromes d'apnées du sommeil › Apnée centrale du sommeil › Prevalence of sleep-disordered breathing in...