What are opioids?

Opioids are derived from the opium poppy. They act as strong painkillers and sedatives, so are extremely useful in medicine. Opioids such as Heroin, Oxycontin and Fentanyl are also used illicitly. Unfortunately opioids have many side effects as well as being highly addictive.

Respiratory side effects

Opioids slow down your breathing. This can cause the carbon dioxide in your body to rise to toxic levels. Normally your body would get rid of this excess carbon dioxide by breathing faster. Unfortunately opioids block this response mechanism.

Opioids and Central Sleep Apnoea

As a long-term opioid user you may have become accustomed to the effects they have on your breathing during the daytime. However, your body may not have adjusted so well during sleep.

When you are asleep your breathing may slow down considerably or even stop completely for a few seconds. Frequent pauses result in Central Sleep Apnoea.

Opioids and abnormal breathing

If you are a long-term opioid user you are at risk of both abnormal breathing patterns and Central Sleep Apnoea. There are two main types of abnormal breathing patterns that may happen while you are asleep:

  • Ataxic breathing – breathing can be erratic with no regular pattern; depth and speed are random.
  • Cluster breathing – there is a pause in breathing followed by a few deep breaths. Unlike ataxic breathing, the pattern is regular.

Opioid dosage

The severity of your breathing problems during sleep often depends on your dose of opioid. The higher the dose, the more abnormal your breathing becomes.

The sleep disruption caused by abnormal breathing patterns may increase your pain, making your current dosage less effective.

It is easy to find yourself caught in a vicious cycle of worsening sleep problems, increasing pain and larger and larger doses of opioid.

If this is happening to you, please talk to your doctor as it may be possible to try an alternative painkiller or take measures to stabilise your sleep.

Alternatives to painkillers

Chronic pain can be debilitating and often leads to depression. When you are low and sad, you may feel pain more acutely. There are alternative therapies that may help.

Physical therapy and manipulation can help to stretch your muscles, move your joints and flood your brain with ‘happy’ chemicals. Massage and relaxation techniques can take your focus away from your pain and release tension. Cognitive behavioural therapy can help you to manage pain.

Gentle yoga with breathing techniques may seem like a huge effort, but it can help to bring your body into alignment, improve your posture, mobilise your joints and bring a rush of oxygen into your body to promote healing and relaxation.

It is important to break the cycle of chronic pain and painkillers, to give you the best possible quality of life.

Opioid side effects

If you take opioids long term you should be monitored closely by your doctor or pain clinic and have a plan of action ready in case you develop side effects. This can involve treating the side effects or trying an alternative painkiller.

What next?

If you take opioids long-term you are at risk of Central Sleep Apnoea and abnormal breathing patterns.

If you notice any breathing-related symptoms it is important to visit your doctor for advice.

To learn about treatments for Central Sleep Apnoea and abnormal breathing patterns please explore our treatments guide.