TY - JOUR
T1 - Central sleep apnea in stable methadone maintenance treatment patients
AU - Wang, David
AU - Teichtahl, Harry
AU - Drummer, Olaf
AU - Goodman, Cathy
AU - Cherry, Gaye
AU - Cunnington, David
AU - Kronborg, Ian
PY - 2005/9
Y1 - 2005/9
N2 - Study objectives: Methadone, a long-acting μ-opioid agonist, is an effective treatment for heroin addiction. Our previous data show that 6 of 10 methaclone maintenance treatment (MMT) patients had central sleep apnea (CSA). This study aims to confirm these results and to investigate the pathogenesis of the CSA. Methods: Twenty-five male and 25 female MMT patients and 20 age-, sex-, and body mass index (BMI)-matched normal subjects were tested with polysomnography, blood toxicology, and ventilatory responses to hypoxia and hypercapnia. Resting cardiorespiratory tests were performed in the MMT group Results: MMT patients and normal subjects were 35 ± 9 years old (mean ± SD), and BMI values were 27 ± 6 kg/m2 and 27 ± 5 kg/m2, respectively. Thirty percent of MMT patients had a central apnea index (CAI) > 5, and 20% had a CAI > 10. All normal subjects had a CAI < 1, and no difference was found in obstructive apnea-hypopnea index between the two groups. Methadone blood concentration was the only significant variable (t = 2.33, p = 0.025) associated with CAI and explains 12% of the variance. Awake PaCO2, antidepressant use, reduced ventilatory response to hyperecapnia, and widened awake alveolar-arterial oxygen pressure gradient together explain a further 17% of the CAI variance. Conclusions: Thirty percent of stable MMT patients have CSA, a minority of which can be explained by blood methadone concentration. Other physiologic variables may also play a role in the pathogenesis of CSA in MMT patients, and further research is indicated in this area.
AB - Study objectives: Methadone, a long-acting μ-opioid agonist, is an effective treatment for heroin addiction. Our previous data show that 6 of 10 methaclone maintenance treatment (MMT) patients had central sleep apnea (CSA). This study aims to confirm these results and to investigate the pathogenesis of the CSA. Methods: Twenty-five male and 25 female MMT patients and 20 age-, sex-, and body mass index (BMI)-matched normal subjects were tested with polysomnography, blood toxicology, and ventilatory responses to hypoxia and hypercapnia. Resting cardiorespiratory tests were performed in the MMT group Results: MMT patients and normal subjects were 35 ± 9 years old (mean ± SD), and BMI values were 27 ± 6 kg/m2 and 27 ± 5 kg/m2, respectively. Thirty percent of MMT patients had a central apnea index (CAI) > 5, and 20% had a CAI > 10. All normal subjects had a CAI < 1, and no difference was found in obstructive apnea-hypopnea index between the two groups. Methadone blood concentration was the only significant variable (t = 2.33, p = 0.025) associated with CAI and explains 12% of the variance. Awake PaCO2, antidepressant use, reduced ventilatory response to hyperecapnia, and widened awake alveolar-arterial oxygen pressure gradient together explain a further 17% of the CAI variance. Conclusions: Thirty percent of stable MMT patients have CSA, a minority of which can be explained by blood methadone concentration. Other physiologic variables may also play a role in the pathogenesis of CSA in MMT patients, and further research is indicated in this area.
KW - Central sleep apnea
KW - Hypercapnic ventilatory response
KW - Hypoxic ventilatory response
KW - Methadone
UR - http://www.scopus.com/inward/record.url?scp=24944493973&partnerID=8YFLogxK
U2 - 10.1378/chest.128.3.1348
DO - 10.1378/chest.128.3.1348
M3 - Article
C2 - 16162728
AN - SCOPUS:24944493973
VL - 128
SP - 1348
EP - 1356
JO - Chest
JF - Chest
SN - 0012-3692
IS - 3
ER -