The effect of acute morphine on obstructive sleep apnoea: a randomised double-blind placebo-controlled crossover trial

ObjectiveAnaesthesiology guidelines suggest that opioids worsen obstructive sleep apnoea (OSA) despite no randomised controlled trial evidence. We therefore conducted a randomised controlled trial to evaluate the effects of a common clinical dose of morphine on OSA, and to identify clinical phenotyp...

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Bibliographic Details
Published in:Thorax 2019-02, Vol.74 (2), p.177-184
Main Authors: Rowsell, Luke, Wong, Keith K H, Yee, Brendon J, Eckert, Danny J, Somogyi, Andrew A, Duffin, James, Grunstein, Ronald R, Wang, David
Format: Article
Language:English
Subjects:
Double-blind studies
Drug dosages
Genotype & phenotype
Medicine
Methadone
Morphine
Narcotics
Pain
Patients
Sleep apnea
Sleep disorders
Substance abuse treatment
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Summary:ObjectiveAnaesthesiology guidelines suggest that opioids worsen obstructive sleep apnoea (OSA) despite no randomised controlled trial evidence. We therefore conducted a randomised controlled trial to evaluate the effects of a common clinical dose of morphine on OSA, and to identify clinical phenotype and genotype vulnerability to opioid-respiratory depression.MethodsUnder a double-blind, randomised, crossover design, 60 male patients with OSA attended two visits to the hospital sleep laboratory, at least 1 week apart. Either 40 mg controlled-release oral morphine or placebo was administered. Awake ventilatory chemoreflex tests were performed post dose and prior to overnight polysomnography monitoring. Blood was sampled before sleep and the next morning for toxicology and genotype analyses. Sleep time with oxygen saturation (SpO2)
ISSN:0040-6376
1468-3296
DOI:10.1136/thoraxjnl-2018-211675