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In Reply: Dr. Geller makes some excellent points about sleep and opioid use.
Opioids pose risks,1 just like any other type of medication. In particular, opioids have been linked to sleep-disordered breathing, which affects 70% to 85% of patients taking opioids.2–4
Other options can be used in some older adults, but they are not always successful. Ideally, nonpharmacologic strategies and nonopioid medications such as acetaminophen, nonsteroidal anti-inflammatory agents, antidepressants, and anticonvulsants should be used, although these medications have their own side effects. Optimum pain control may offer the potential for significant improvement in function, and opioids are but one tool in the clinician’s kit.
Ongoing discussions of the risks and benefits are necessary, along with continuous re-evaluation of the need for and effect of opioids.
- Davis MP, Mehta Z. Opioids and chronic pain: where is the balance? Curr Oncol Rep 2016; 18:71.
- Jungquist CR, Flannery M, Perlis ML, Grace JT. Relationship of chronic pain and opioid use with respiratory disturbance during sleep. Pain Manag Nurs 2012; 13:70–79.
- Webster LR, Choi Y, Desai H, Webster L, Grant BJ. Sleep-disordered breathing and chronic opioid therapy. Pain Med 2008; 9:425–432.
- Mogri M, Khan MI, Grant BJ, Mador MJ. Central sleep apnea induced by acute ingestion of opioid. Chest 2008; 133:1484–1488.
In Reply: Dr. Geller makes some excellent points about sleep and opioid use.
Opioids pose risks,1 just like any other type of medication. In particular, opioids have been linked to sleep-disordered breathing, which affects 70% to 85% of patients taking opioids.2–4
Other options can be used in some older adults, but they are not always successful. Ideally, nonpharmacologic strategies and nonopioid medications such as acetaminophen, nonsteroidal anti-inflammatory agents, antidepressants, and anticonvulsants should be used, although these medications have their own side effects. Optimum pain control may offer the potential for significant improvement in function, and opioids are but one tool in the clinician’s kit.
Ongoing discussions of the risks and benefits are necessary, along with continuous re-evaluation of the need for and effect of opioids.
In Reply: Dr. Geller makes some excellent points about sleep and opioid use.
Opioids pose risks,1 just like any other type of medication. In particular, opioids have been linked to sleep-disordered breathing, which affects 70% to 85% of patients taking opioids.2–4
Other options can be used in some older adults, but they are not always successful. Ideally, nonpharmacologic strategies and nonopioid medications such as acetaminophen, nonsteroidal anti-inflammatory agents, antidepressants, and anticonvulsants should be used, although these medications have their own side effects. Optimum pain control may offer the potential for significant improvement in function, and opioids are but one tool in the clinician’s kit.
Ongoing discussions of the risks and benefits are necessary, along with continuous re-evaluation of the need for and effect of opioids.
- Davis MP, Mehta Z. Opioids and chronic pain: where is the balance? Curr Oncol Rep 2016; 18:71.
- Jungquist CR, Flannery M, Perlis ML, Grace JT. Relationship of chronic pain and opioid use with respiratory disturbance during sleep. Pain Manag Nurs 2012; 13:70–79.
- Webster LR, Choi Y, Desai H, Webster L, Grant BJ. Sleep-disordered breathing and chronic opioid therapy. Pain Med 2008; 9:425–432.
- Mogri M, Khan MI, Grant BJ, Mador MJ. Central sleep apnea induced by acute ingestion of opioid. Chest 2008; 133:1484–1488.
- Davis MP, Mehta Z. Opioids and chronic pain: where is the balance? Curr Oncol Rep 2016; 18:71.
- Jungquist CR, Flannery M, Perlis ML, Grace JT. Relationship of chronic pain and opioid use with respiratory disturbance during sleep. Pain Manag Nurs 2012; 13:70–79.
- Webster LR, Choi Y, Desai H, Webster L, Grant BJ. Sleep-disordered breathing and chronic opioid therapy. Pain Med 2008; 9:425–432.
- Mogri M, Khan MI, Grant BJ, Mador MJ. Central sleep apnea induced by acute ingestion of opioid. Chest 2008; 133:1484–1488.
