Opioid sensitivity in treated and untreated obstructive sleep apnoea: a prospective cohort study
Authors' conclusion
Neither obstructive sleep apnoea nor obstructive sleep apnoea treatment affected sensitivity to the miotic, sedative, analgesic, or respiratory depressant effects of the opioid remifentanil in awake adults.
Study context
- Population
- Awake adults with or without obstructive sleep apnoea (OSA) (verified by type III in-home polysomnography) receiving stepped-dose remifentanil infusion (target effect-site concentrations 0.5, 1, 2, 3, 4 ng ml-1)
- Participants
- 20 / 33 / 21
- Exposure
- Untreated OSA and treated OSA (continuous positive airway pressure (CPAP) or bilevel positive airway pressure (BIPAP)) vs no OSA: sensitivity to stepped-dose remifentanil
- Without OSAn = 20reference
- Untreated OSAn = 33
- Treated OSAn = 21
- Outcome
- Miosis (pupil area fractional change)
Methodological detailssingle-centre
- Single-centre
Main finding
As reported in the abstract
Untreated OSA
0.51
mean · 95% CI 0.41–0.61
Without OSA
0.49
mean · 95% CI 0.36–0.62
Treated OSA
0.56
mean · 95% CI 0.43–0.68
Estimate (95% CI)
Untreated OSA vs Without OSA
mean difference 0.02(−0.18 to 0.22)
Treated OSA vs Without OSA
difference 0.07(−0.16 to 0.29)
Untreated OSA vs Treated OSA
difference −0.05(−0.25 to 0.16)
Observational data: associations, not effects.
Secondary outcomes
Ventilatory rate, end-expired CO2, sedation, thermal analgesia
- No significant differences between without OSA, untreated OSA and treated OSA
OSA severity vs magnitude of opioid effects
- No relationship between OSA severity and magnitude of opioid effects
Original publication
Opioid sensitivity in treated and untreated obstructive sleep apnoea: a prospective cohort study. Br J Anaesth. Published 7 November 2023. doi:10.
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