Sleep Care

Narcotics and Sleep

Painkillers are part of everyday life for many Americans. For those with severe pain, undergoing surgery or recovering from surgery more powerful narcotics are needed to effectively treat their pain. However, these drugs do not come without risks, including drowsiness, slowed heart rate, addiction and nausea. One risk that many are not aware of is the affect narcotics can have on breathing, and especially breathing during sleep.

Sleep apnea is a common sleeping disorder that involves the

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airway closing off during sleep, preventing oxygen from entering the lungs and the bloodstream. Sleep apnea is common among individuals who are overweight or have excess tissue in and around the throat. When the airway closes and the body is not getting enough oxygen the brain signals the body to wake up and take a deep breath to get the air it needs. Sometimes the sufferer is aware of these awakenings but many times this happens without being fully conscious.

Numerous studies have been performed to look at the effects of narcotics on sleep. The results showed three serious problems that narcotics present for sleep-related breathing. First, the relaxing nature of the drugs can create or worsen the apnea-like symptoms by relaxing the airway and allowing it to close off. This can both cause someone without apnea to experience breathing problems while on the narcotics, and it can worsen an already dangerous condition in those that have existing sleep apnea.

Second is the affect narcotics have on the ability to arouse the user. Narcotics are intended to sedate patients, keeping them asleep and block pain signals to the brain. These drugs are also effective at blocking other signals to the brain such as the signal to breathe. This causes the sufferer to go longer without breathing, allowing less oxygen to get to the body.

Lastly, certain narcotics are known to reduce heart rate. This factor can further decrease the amount of oxygen reaching the organs and brain as less blood is being pumped by the heart. The compounded effects of these issues can result in numerous health risks, most of all cardiac arrest and death. Even those with low body mass indexes (BMI), who were previously thought to not be at risk for apnea, have been shown to develop sleep-related breathing issues when under the influence of powerful narcotics. The greatest danger still remains when those with high BMI and existing apnea are taking narcotics.

The best method to eliminate breathing issues during surgery or while taking narcotics is with the use of a Continuous Positive Airway Pressure machine (CPAP). CPAP is the most common and effective treatment for sleep apnea as the device gently pushes room air into the airway to keep it from closing. This allows the person to breathe without issue, even under the influence of narcotics.

Anytime surgery or narcotics are being considered it is important to speak with your physician about potential risks that are involved. There are numerous screening options available, including a full sleep study, which is the most effective tool to identify sleep-related breathing issues. Existing CPAP users should always bring their machine with them anytime they are undergoing surgery or taking narcotics. Those who snore or are over-weight should speak with their physician about the risks of going under anesthesia or using narcotics.

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