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Pain killers as a sleep aid
#1
I have suffered from fragmented sleep since before starting CPAP therapy three years ago, and it continues unchanged. In a normal night I will sleep for two hours before waking up the first time, thereafter about once every hour and a half, although as I get toward morning I sleep only about an hour at a time. Needless to say, I have tried everything that has ever been suggested here, to no avail.

A few days ago I started to have horrible pain when swallowing. Because my friend Mr. Google seemed to be convinced that my symptoms matched strep throat I went to a local hospital where they took a swab for a culture and blood to test my white cell count. The culture was negative and my white cell count was perfectly normal - in other words it's not an infection. The next step was a scan and the hospital seemed reluctant to put me through that without giving it a little longer to see if it will go away by itself. I agreed, and they sent me home with oxycodone 5mg.

I went to bed that night at 10pm and before doing so I took 4 ibuprofen (my usual preferred pain med), one of the oxycodone, plus 4mg hydromorphone that I had left over from a recent operation. Did I mention that my throat really freaking HURT?

I put all the above bottles on the nightstand with a glass of water, anticipating the need to re-dose in the middle of the night. Imagine my surprise when I woke up, looked at the clock, and it said 4:10. I slept for six hours straight! The pills had worn off so I re-dosed, rolled over and went back to sleep. When I next work up it was after 8am - another four hours straight!

Now, I'm not planning on doing this every night from now on. Becoming addicted to pain meds is not in my plan book. But I am curious if anyone else has encountered similar effects from serious pain meds. I'd also like to know if anyone has encountered any professional journal articles on pain meds and sleep.
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#2
you sound like me about 6 months ago, except the sore throat. Mine was every hour to start and then progressed to up every 30 minutes. THe path has been long, and I am not suggesting that my path is your path, just that it can be long and twisted:
1. APAP, not much improvement
2. VPAP (BiLevel) still not much
3. Dx for COPD and now I was waking up every 2 hours, hopeful
4. changed Timax to 3, 3.2, 2.4 then 4 seconds and better again
5.Doctor gave up and said I could do anything I wanted.
6.With advice from here, after looking at my plots, increased minimum pressure and again and again , better each time
7. only waking up for bio breaks now. It was suggested that my pressure was too low and although I was not going into full apnea, I was going to zero flow and recovering-over and over for hours all night, not very restful at all.

Hang in there and don't give up until there is nothing left to try.
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#3
(07-20-2016, 12:11 AM)JJJ Wrote: I'd also like to know if anyone has encountered any professional journal articles on pain meds and sleep.
Read somewhere that opioid medication can cause breathing problems during sleep and central sleep apnea in some people
I haven't kept the links, but google can come up with few reliable sources



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#4
I, too, took pain meds for a gallbladder attack and found that I had a wonderful night's sleep. But, thankfully, the pain was gone the next day. I mentioned this to my sleep doctor during one of our periodic visits and he suggested I speak with him before doing more than a single night's worth of pain meds.

If you are interested in opioids and sleep therapy, you may wish to read The Epidemic of Opioid Use: Implications for the Sleep Physician which can be found at http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4031405/.

"Opioid induced sleep apnea falls within the spectrum of complex sleep apnea, characterized by a combination of obstructive apneas and central sleep disordered breathing. The respiratory pattern may be periodic or non-periodic. The periodic form may be similar to other forms of central apneas or Cheyne-Stokes respiration but typically has a shorter cycle length."
"The object in life is not to be on the side of the majority, but to escape finding oneself in the ranks of the insane." -- Marcus Aurelius
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#5
Oxycodone, Oxycontin, Roxicodone - all names for the same drug - is one MF powerful pain killer. It's nickname is Hillbilly Heroin and that in itself says a lot.

I'm lying in my hospital bed in ICU after a triple bypass at 2:00am looking at a blank wall that suddenly came alive. The images, all moving, were reminiscent of the paintings of Heironymous Bosch. I hit the emergency bell and the night nurse was there very quickly. After discussing what I'd seen she looked at my charts and quickly deduced that oxycontin was the culprit. A change of pain meds solved the problem. Oxycodone, a powerful opioid is powerful sh*t. It does far more than just kill pain.
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#6
Opioids scare the crap out of me. Had Demerol after an appendectomy and figured I could get really used to it really quickly. No more. I'll take 2 ibuprofin if the arthritis in my big toes is killing me (not gout, just feels similar).

On the throat pain, for a long time I'd get a killer sore throat every September where I lived. The last time it happened, the urgent care center was busy, but an allergist was free. Turns out I was wildly allergic to Chinese Elm pollen, which bloomed that time of year. (American Elm blooms in the spring, causing similar, but less severe symptoms.) The drainage from my sinuses was going down the back of my throat and inflaming that tissue.

Eventually, I went to immunotherapy (green-goop shots), but the short term fix was a solid antihistamine. Food for thought.
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#7
Pretty sure I got this right, stuck with me anyway. When Whitney Houston passed there were a lot of Doctors on the news talking about brain stems, opioids, alcohol and Maryjane (as I remember it). They all effect the brain stem, and for us so do centrals, you sedate the brain stem to much and you take a long, very long nap.

Please be careful out there.
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#8
Thanks to all for the thoughts and suggestions.

Last night's sleep was back to my usual fragmented sleep, even though I was on the same doses of the pain meds as the previous night. So apparently my theory was worthless. Oh well.

I may not see replies right away because the pain has not abated, so I'm going back to the hospital. I'm taking my CPAP just in case I have to stay overnight. Y'all keep your fingers crossed that the scan turns up something benign and easily remedied, 'cause you know the big C that we all worry about.
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#9
Opiod pain medications can cause great sleep or fragmented sleep, depending on the person and how long they have been taking them. Sometimes I sleep great and other times I wake up every hour. Annoying as heck. I think it is also related to the pain itself. Just because the brain is being blocked from receiving the pain signal does not mean the pain is not there. Whatever is hurting is still hurting. My late night can't sleep so I think weird things thought is that sometimes the pain reliever also helps whatever is actually in pain and sometimes it doesn't. When it doesn't, that's when i can't sleep as well.

As for AHI, if I only need the narcotic for one night, I don't often notice a chance in readings. Unless I have taken more than one that day. But if it is day two or more, then I notice a drastic increase in central events and, if I am sleeping solid, an increase in OA.
PaulaO2
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#10
Hi JJJ,
I hope they find out what's going on with you and that you get to feeling better, soon.
trish6hundred
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