The effects of a single mild dose of morphine on chemoreflexes and breathing in obstructive sleep apnea

David Wang*, Andrew A. Somogyi, Brendon J. Yee, Keith K. Wong, Jasminder Kaur, Paul J. Wrigley, Ronald R. Grunstein

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

34 Citations (Scopus)

Abstract

The effect of morphine on breathing and ventilatory chemoreflexes in obstructive sleep apnea (OSA) is unknown. It has been assumed that acute morphine use may induce deeper respiratory depression in OSA but this has not been investigated. We evaluated awake ventilatory chemoreflexes and overnight polysomnography on 10 mild-moderate OSA patients before and after giving 30mg oral controlled-release morphine. Morphine plasma concentrations were analysed. We found a 30-fold range of morphine plasma concentrations with the fixed dose of morphine, and a higher plasma morphine concentration was associated with a higher CO2 recruitment threshold (VRT) (r=0.86, p=0.006) and an improvement in sleep time with SpO2<90% (T90) (r=-0.87, p=0.005) compared to the baseline. The improvement in T90 also significantly correlated with the increase of VRT (r=-0.79, r=0.02). In conclusion, in mild-to-moderate OSA patients, a single common dose of oral morphine may paradoxically improve OSA through modulating chemoreflexes. There is a large inter-individual variability in the responses, which may relate to individual morphine metabolism.

Original languageEnglish
Pages (from-to)526-532
Number of pages7
JournalRespiratory Physiology and Neurobiology
Volume185
Issue number3
DOIs
Publication statusPublished - 1 Feb 2013
Externally publishedYes

Keywords

  • Chemosensitivity
  • Opioid
  • Respiratory control
  • Respiratory depression
  • Sleep apnoea
  • Ventilatory response

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