Managing acute pain in people with sleep-disordered breathing

The general principles of acute pain management are applicable to adults and children with sleep-disordered breathing. Sleep-disordered breathing causes hypoxia and sleep fragmentation, which may be associated with an increased sensitivity to pain and an increased sensitivity to opioids. Opioid-sparing analgesic regimens are recommended (when possible) because patients may be at increased risk of opioid-induced ventilatory impairment.

Postoperatively, patients with sleep-disordered breathing are at increased risk of cardiorespiratory complications, including opioid-induced ventilatory impairment. The risk is highest in the first 24 hours after opioids are commenced and is further increased by co-administration of sedative drugs. Effective monitoring and early identification of opioid-induced ventilatory impairment is crucial.

Sleep-disordered breathing may develop after opioid administration.