Central Sleep Apnea and Duragesic (fentanyl) patch

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
Posts: 26
Joined: Sat Apr 30, 2005 9:36 pm
Location: Republic, Missouri

Central Sleep Apnea and Duragesic (fentanyl) patch

Post by MoSleep » Mon Aug 22, 2005 8:50 pm

Eighteen months ago I started using the duragesic fentanyl patch for control of chronic pain. The patch is a very strong narcotic pain reliever. After using the patch for several months my wife began to notice that I was having spells of not breathing while I slept. As time went on the periods of no breathing became longer and more frequent. I was having problems staying awake during the day. During a Doctor visit I mentioned the problems I was having and was scheduled for a sleep study. I was diagnosed with severe Central Sleep Apnea, having over 55 centrals an hour even while on the machine. After further complications I visited another sleep doctor for 2 more sleeep studies with the same results. I asked the doctors if the use of the patch might be a cause of the centrals and none of them thought it likely or were willing to take me off of the patch. After doing some research on my own I came to the realization that the patch could possibly be the cause of the centrals. I quit the patch, which was no easy task, and have had no signs of Central Sleep Apnea since.
I believe the use of the Fentanyl duragesic patch was the cause of my Apnea and am curious about the opinions of other Apnea sufferers.

User avatar
rested gal
Posts: 12892
Joined: Thu Sep 09, 2004 10:14 pm
Location: Tennessee

Post by rested gal » Mon Aug 22, 2005 11:56 pm

Very interesting, Dave. I'm sure you did a lot more research than I did with a Google search after reading your post. A quick look turned up these items. While they don't mention "central apneas", the references to shallow breathing, hypoventilation, and apnea would give one something to think about.

Did you have (or plan to have) a follow-up PSG to see if you truly are free of the central apneas now?



Hypoventilation was the most serious adverse reaction observed in 13 (4%) postoperative patients and in 3 (2%) of the cancer patients.

Respiratory: Dyspnea*, hypoventilation*, apnea*
*Reactions occurring in 3% - 10% of DURAGESIC® patients


FDA Issues Public Health Advisory on the Fentanyl Patch

FDA Statement

July 15, 2005

Media Inquiries:
Laura Alvey, 301-827-6242
Consumer Inquiries:

FDA Issues Public Health Advisory on the Fentanyl Patch

Following the link to "more information" led to this in a PDF file called "Healthcare Professional Information":

Health care professionals who prescribe the fentanyl transdermal patch and patients who use the fentanyl transdermal patch and their caregivers should be aware of the signs of fentanyl overdose. Signs of fentanyl overdose include trouble breathing or shallow breathing; tiredness, extreme sleepiness or sedation; inability to think, talk or walk normally; and feeling faint, dizzy or confused. If these signs occur, patients or their caregivers should get medical attention right away.

Posts: 149
Joined: Fri Jul 01, 2005 10:02 pm

Post by gracie97 » Tue Aug 23, 2005 3:09 am

Think any opiate, not just fentanyl, could have a similar effect. After all, breathing cessation is how those drugs kill in overdose situation.

Fentanyl may be particularly dangerous that way, however, as heat makes the patch medication enter the body more quickly. Sleeping conditions may therefore stimulate more rapid release at nightt.

There have been accidental overdose deaths from fentanyl merely from the victims sleeping on heated waterbeds.

Can't have been easy to see your way out of that fix when afflicted with such an atrocious rate of central apnea!

Started CPAP on 7/1/2005
Mild apnea
Plus upper airway resistance syndrome with severe alpha intrusion