Opioids, steep architecture and steep-disordered breathing

Opioid use whether acute or chronic, illicit or therapeutic is prevalent in Western societies. Opioid receptors are located in the same nuclei that are active in steep regulation and opioid peptides are suggested to be involved in the induction and maintenance of the steep state. mu-Opioids are the most commonly used opioids and are recognized respiratory depressants that cause abnormal awake ventilatory responses to hypercapnia and hypoxia. Abnormal steep architecture has been reported during the process of opioids induction, maintenance and withdrawal. During induction and maintenance of opioid use there is reduction of rapid eye movement (REM) sleep and stow wave steep. More recently, central steep apnoea (CSA) has been reported with chronic opioid use and 30% of stable methadone maintenance treatment patients have CSA. Given these facts, it is sobering to note the paucity of human data available regarding the effects of short and long-term opioid use on steep architecture and respiration during steep. In this manuscript, we review the current knowledge regarding the effects of mu-opioids on steep and respiration during steep and suggest research pathways to advance our knowledge and to explore the possible responsible mechanisms related to these effects. (C) 2006 Elsevier Ltd. All rights reserved.