Effects of opioid, hypnotic and sedating medications on sleep-disordered breathing in adults with obstructive sleep apnoea

作者：Martina Mason, Christopher J Cates, Ian Smith · 发表于：Cochrane Database of Systematic Reviews · 年份：2015 · DOI：10.1002/14651858.cd011090.pub2 · 被引用次数：131 · 研究领域：Obstructive Sleep Apnea Research、Sleep and related disorders、Neuroscience of respiration and sleep

BACKGROUND: Obstructive sleep apnoea (OSA) is a common sleep disorder characterised by partial or complete upper airway occlusion during sleep, leading to intermittent cessation (apnoea) or reduction (hypopnoea) of airflow and dips in arterial oxygen saturation during sleep. Many patients with recognised and unrecognised OSA receive hypnotics, sedatives and opiates/opioids to treat conditions including pain, anxiety and difficulty sleeping. Concerns have been expressed that administration of these drugs to people with co-existing OSA may worsen OSA. OBJECTIVES: To investigate whether administration of sedative and hypnotic drugs exacerbates the severity of OSA (as measured by the apnoea-hypopnoea index (AHI) or the 4% oxygen desaturation index (ODI)) in people with known OSA. SEARCH METHODS: We searched the Cochrane Airways Group Specialised Register (CAGR) of trials. The search was current as of March 2015. SELECTION CRITERIA: Randomised, placebo-controlled trials including adult participants with confirmed OSA, where participants were randomly assigned to use opiates or opioids, sedatives, hypnotics or placebo. We included participants already using continuous positive airway pressure (CPAP) or a mandibular advancement device. DATA COLLECTION AND ANALYSIS: We used standard methodological procedures as recommended by The Cochrane Collaboration. MAIN RESULTS: Fourteen studies examining the effects of 10 drugs and including a total of 293 participants contributed to this revie...