Central sleep apnea in the past has been most strongly linked to heart failure or neurologic disorders like stroke. In these cases it's presumably a combination of chronic pain and the opioid treatment prescribed for it.

The first step is making sure that those who treat patients in chronic severe pain are aware of how common the problem with sleep apnea is, Webster said. He's working to develop protocols looking at the most appropriate treatment for the degrees of both obstructive and central sleep apnea. Treating the sleep apnea may reduce the amount of pain someone experiences and thus the amount of medication needed to cope with it.

"The recent flurry of news reports of deaths associated with methadone use and the synergy of opioids and benzodiazepines in causing respiratory depression highlight the importance of Dr. Webster's research," said Dr. Rollin M. Gallagher, editor of Pain Medicine. "Clearly we need more studies of these mechanisms as well as ways of identifying those at risk. Doctors and patients who are considering opioid medication for pain control must balance this risk against the potential for improved quality of life."

The researchers examined sleep lab data on 140 patients who were taking around-the-clock opioid therapy for chronic pain. All patients had been on the opioid therapy at least six months, with stable dosing for at least four weeks.

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E-mail: lois@desnews.com