Animal studies suggest that opioids inhibit hypoglossal motor-neuron and genioglossal muscle activity and induce upper air-way obstruction like OSA, but mechanisms are insufficiently understood. While there is a consensus that opioids cause central sleep apnea, the effects of opioids on OSA in clinical studies are not uniform and depend on the disease phenotype. Large clinical studies addressing the role of phenotypic traits,such as upper airway muscle response to pharyngeal obstruction, chemo reflex, and the arousal threshold, may identify the patients with OSA at risk of  opioid-induced respiratory depression.
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