Screening for obstructive sleep apnoea in tramadol users: A case-control study

Background Although opioids are known to cause sleep apnoea, to date, the risk for obstructive sleep apnoea (OSA) in individuals abusing tramadol has not been investigated. Therefore, we aimed to investigate the risk for OSA in individuals abusing tramadol. Patients and methods We conducted a case-control study comparing 100 patients with tramadol addiction with 100 healthy controls, assessing them for risk for OSA with the STOP-Bang questionnaire and for risk for daytime sleepiness with the Epworth Sleepiness Scale (ESS). We correlated between Severity of Dependence Scale, STOP-bang and ESS scores. Results Individuals abusing tramadol had significantly higher scores (P<0.001) on both STOP-bang and ESS compared with healthy controls. However, both the patient and control groups scored less than 3 on the STOP-bang, indicating that neither group reached the threshold for being high risk for OSA. Correlation of Severity of Dependence Scale scores with STOP-bang and ESS scores showed a statistically significant negative correlation (P<0.001 for both). Correlation between STOP-bang scores and ESS scores showed a statistically significant positive correlation (P<0.001). Conclusion Our study was the first to specifically examine the risk for OSA in individuals abusing tramadol. We found a significantly higher risk for OSA and more daytime sleepiness compared with healthy controls. However, OSA risk in both the patient and control groups did not reach the threshold for being high risk for OSA. We also found a significant negative correlation for dependence severity with OSA risk and daytime sleepiness, and a significant positive correlation between OSA risk and daytime sleepiness.