1166 Long-term Buprenorphine Use and Prevalence of Sleep Apnea: A Case Series

Abstract Introduction It has been well documented that opiate use is a risk factor for developing sleep apnea. We suspect that buprenorphine being a partial-opioid-agonist to also be a risk factor for developing sleep apnea. Study by Farney et al showed an association between Buprenorphine use and sleep apnea. But the literature also has contradictory findings in which a publication by Grunstein et al showed that by switching from methadone to buprenorphine pre-existing sleep apnea was eliminated, although this study only observed the effects of only short-term buprenorphine use. There is a gap in understanding the prevalence and specific risk factors associated with sleep apnea in chronic buprenorphine. Report of case(s) Patient 1: 46-year-old male. Medical History: Obesity, hypertension, coronary artery disease. Former smoker (15 pack year smoking history) Buprenorphine Use: 6 years for opioid dependence. Sleep Study: Central sleep apnea- hypopnea index of 10.3, unresponsive to CPAP titration. Patient 2: 66-year-old male Medical history: Chronic back pain, smoker Buprenorphine Use: 6 years for chronic back pain. Sleep Study: Central sleep apnea- hypopnea index of 4.5, unresponsive to CPAP titration. Patient 3: 47-year-old female. Medical History: Obesity, narcolepsy. Buprenorphine Use: 6 years. Sleep Study: No evidence of central sleep apnea on initial and subsequent studies. Patient 4: 28-year-old male. Medical History: Obesity. Buprenorphine Use: 8 years for chronic pain or opioid dependence. Sleep Study: No central sleep apnea on initial study. Subsequent study revealed central sleep apnea with central apnea- hypopnea index (AHI) of 2.9. Patient 5: 68-year-old male. Medical History: Atrial fibrillation, hyperlipidemia, chronic kidney disease, cigarette smoker, obesity. Buprenorphine Use: 8 years for chronic pain or opioid dependence. Sleep Study: Initial study showed central AHI of 0.5. Subsequent study revealed an increase in central AHI to 13.1. Conclusion The presented cases raise awareness of a possible link between long- term buprenorphine use and sleep apnea. This case series underscores the importance of monitoring individuals on long-term buprenorphine therapy for the potential development of sleep apnea. Further research is needed to elucidate the underlying mechanisms and explore management strategies for individuals facing this complication of buprenorphine therapy. Support (if any)