Case of buprenorphine-associated central sleep apnea resolving with dose reduction

Vladimir Tchikrizov, MD; Allen C. Richert, Jr, MD; Saurabh B. Bhardwaj, MD

doi:10.5055/jom.2022.0732

Authors

Vladimir Tchikrizov, MD https://orcid.org/0000-0002-2429-7529
Allen C. Richert, Jr, MD
Saurabh B. Bhardwaj, MD https://orcid.org/0000-0002-8845-0182

DOI:

https://doi.org/10.5055/jom.2022.0732

Keywords:

buprenorphine, apnea, central, sleep, management

Abstract

Aside from respiratory suppression in overdose, full opioid agonist agents are known to cause sleep-disordered breathing (SDB). The increasing rates of opioid overdose in the United States have led to increasing use of medication-assisted treatments for opioid use disorders. Dose-dependent increase in SDB has been documented with methadone. There is emerging literature in the form of case reports providing evidence of buprenorphine and buprenorphine–naloxone contributing to sleep apnea. We report an additional case of a female patient developing central sleep apnea during initiation of buprenorphine–naloxone treatment. The condition resolved with dose reduction.

Author Biographies

Vladimir Tchikrizov, MD

Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, Jackson, Mississippi

Allen C. Richert, Jr, MD

Associate Professor, Psychiatry, Division Director, Sleep Medicine, Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, Jackson, Mississippi

Saurabh B. Bhardwaj, MD

Medical Director, Center for Innovation & Discovery in Addictions (CIDA), Assistant Professor, Department of Psychiatry & Human Behavior, Jackson, Mississippi

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