Heinzer Raphael
Service de pneumologie et Centre d'investigation et de recherche sur le sommeil, (CIRS), CHUV, 1011 Lausanne.
Rev Med Suisse. 2009 Nov 18;5(226):2322-4, 2326-8.
Medical use of chronic opioids has recently increased in Switzerland. Even though their effect on daytime vigilance tends to disappear after some time, 70% of chronic opioid users will suffer from sleep disordered breathing. Most of them will show an ataxic breathing during sleep with mostly central apnea alternating with short breathing periods, but long hypopnea may also occur. Treatment with continuous positive airway pressure (CPAP) is usually ineffective. More sophisticated ventilatory modes such as bilevel ventilation with backup respiratory rate or adaptive servoventilation are often required. Older patients with concomitant COPD or obstructive sleep apnea are at higher risk of developing nocturnal breathing disorders.
近年来，瑞士慢性阿片类药物的医疗使用有所增加。尽管其对日间警觉性的影响一段时间后往往会消失，但70%的慢性阿片类药物使用者会出现睡眠呼吸障碍。他们中的大多数人在睡眠期间会出现共济失调性呼吸，主要是中枢性呼吸暂停与短呼吸周期交替出现，但也可能出现长时间的呼吸浅慢。持续气道正压通气（CPAP）治疗通常无效。通常需要更复杂的通气模式，如带有备用呼吸频率的双水平通气或适应性伺服通气。患有慢性阻塞性肺疾病（COPD）或阻塞性睡眠呼吸暂停的老年患者发生夜间呼吸障碍的风险更高。
