# The impact of central sleep apnea in patients receiving medications for opioid use disorder

> **NIH NIH R01** · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · 2024 · $1,102,714

## Abstract

ABSTRACT
 Opioid use disorder has reached epidemic proportions in the US causing substantial mortality and morbidity.
While medication treatment for opioid use disorder (MOUD) can improve clinical outcomes, relapse rates remain
high. In addition, common medications used for MOUD such as methadone and buprenorphine have been found
to cause central sleep apnea (CSA) in as many as 30% of patients receiving treatment. Given the high
prevalence of sleep complaints in patients on MOUD and evidence that CSA causes sleep fragmentation and
intermittent hypoxemia that have been associated with adverse clinical consequences in other forms of sleep-
disordered breathing, there is an urgent need to better understand whether CSA caused by MOUD has an
adverse effect on clinical outcomes and the mechanistic pathways implicated. Preliminary data suggest CSA
may lead to sympathetic activation and nocturnal arousal which in turn exacerbate emotional distress and drug
craving that can then increase risk of drug relapse and reduce treatment retention.
 In this proposal, we will use home sleep apnea testing to identify a cohort of patients receiving MOUD therapy
with CSA and a control population without any sleep-disordered breathing, confirm CSA status with
polysomnography, and assess differences in sleep, autonomic nervous system function, nocturnal arousal,
anxiety, depression, and drug craving. We will also assess longitudinally the risk of drug lapses and treatment
retention rates over six months in the two groups. This work will establish whether CSA is associated with worse
outcomes among patients receiving MOUD therapy and the extent to which sympathetic activation and nocturnal
arousal play roles in mediating this effect. In addition, we will conduct a short-term randomized trial of
acetazolamide versus placebo in 40 patients receiving MOUD therapy with CSA to evaluate the impact of treating
CSA on improving sleep quality, restoring autonomic balance, and reducing nocturnal arousal, emotional
distress, and drug craving.
 Results from this proposal will advance understanding of the impact of CSA among patients receiving MOUD
therapy and help establish the role of sympathetic activation and nocturnal arousal in mediating the adverse
effects of this increasingly common form of sleep-disordered breathing. Our findings will advance understanding
of the potential importance of identifying and treating CSA in patients receiving MOUD as a means to improve
clinical outcomes. Our work will also help identify potential interventions to limit the adverse impact of CSA in
this population.

## Key facts

- **NIH application ID:** 10931746
- **Project number:** 5R01DA059465-02
- **Recipient organization:** UNIVERSITY OF PITTSBURGH AT PITTSBURGH
- **Principal Investigator:** Sanjay R Patel
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $1,102,714
- **Award type:** 5
- **Project period:** 2023-09-30 → 2027-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10931746

## Citation

> US National Institutes of Health, RePORTER application 10931746, The impact of central sleep apnea in patients receiving medications for opioid use disorder (5R01DA059465-02). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10931746. Licensed CC0.

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