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

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


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.



buprenorphine, apnea, central, sleep, management

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