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These often occur during sleep. Opioids such as morphine may worsen obstructive sleep apnoea (OSA). Thus, people with OSA may be at greater risk of harm from morphine. Possible mechanisms include respiratory depression and reductions in drive to the pharyngeal muscles to increase upper airway collapsibility. However, the effects of morphine on the four key phenotypic causes of OSA (upper airway collapsibility (pharyngeal critical closure pressure;<jats:italic>P<\/jats:italic><jats:sub>crit<\/jats:sub>), pharyngeal muscle responsiveness, respiratory arousal threshold and ventilatory control (loop gain) during sleep) are unknown.<\/jats:p><jats:p>21 males with OSA (apnoea\u2013hypopnoea index range 7\u201367\u2005events\u00b7h<jats:sup>\u22121<\/jats:sup>) were studied on two nights (1-week washout) according to a double-blind, randomised, cross-over design (ACTRN12613000858796). Participants received 40\u2005mg of MS-Contin on one visit and placebo on the other. Brief reductions in continuous positive airway pressure (CPAP) from the therapeutic level were delivered to induce airflow limitation during non-rapid eye movement (REM) sleep to quantify the four phenotypic traits. Carbon dioxide was delivered<jats:italic>via<\/jats:italic>nasal mask on therapeutic CPAP to quantify hypercapnic ventilatory responses during non-REM sleep.<\/jats:p><jats:p>Compared to placebo, 40\u2005mg of morphine did not change<jats:italic>P<\/jats:italic><jats:sub>crit<\/jats:sub>(\u22120.1\u00b12.4<jats:italic>versus<\/jats:italic>\u22120.4\u00b12.2\u2005cmH<jats:sub>2<\/jats:sub>O, p=0.58), genioglossus muscle responsiveness (\u22122.2 (\u22120.87 to \u22125.4)<jats:italic>versus<\/jats:italic>\u22121.2 (\u22120.3 to \u22123.5) \u03bcV\u00b7cmH<jats:sub>2<\/jats:sub>O<jats:sup>\u22121<\/jats:sup>, p=0.22) or arousal threshold (\u221216.7\u00b16.8<jats:italic>versus<\/jats:italic>\u221215.4\u00b16.0\u2005cmH<jats:sub>2<\/jats:sub>O, p=0.41), but did reduce loop gain (\u221210.1\u00b12.6<jats:italic>versus<\/jats:italic>\u22124.4\u00b12.1, p=0.04) and hypercapnic ventilatory responses (7.3\u00b11.2<jats:italic>versus<\/jats:italic>6.1\u00b11.5\u2005L\u00b7min<jats:sup>\u22121<\/jats:sup>, p=0.006).<\/jats:p><jats:p>Concordant with recent clinical findings, 40\u2005mg of MS-Contin does not systematically impair airway collapsibility, pharyngeal muscle responsiveness or the arousal threshold in moderately severe OSA patients. However, consistent with blunted chemosensitivity, ventilatory control is altered.<\/jats:p>","DOI":"10.1183\/13993003.01344-2019","type":"journal-article","created":{"date-parts":[[2020,3,12]],"date-time":"2020-03-12T18:04:24Z","timestamp":1584036264000},"page":"1901344","update-policy":"https:\/\/doi.org\/10.1183\/ers-crossmark-policy","source":"Crossref","is-referenced-by-count":24,"title":["Morphine alters respiratory control but not other key obstructive sleep apnoea phenotypes: a randomised trial"],"prefix":"10.1183","volume":"55","author":[{"given":"Rodrigo T.","family":"Martins","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jayne C.","family":"Carberry","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luke","family":"Rowsell","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ronald R.","family":"Grunstein","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3503-2363","authenticated-orcid":false,"given":"Danny J.","family":"Eckert","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"81","published-online":{"date-parts":[[2020,3,12]]},"reference":[{"key":"2024102101265264000_55.6.1901344.1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1445-5994.2009.01982.x"},{"key":"2024102101265264000_55.6.1901344.2","doi-asserted-by":"crossref","first-page":"745","DOI":"10.1016\/j.amepre.2017.06.009","article-title":"Geographic variation in opioid and heroin involved drug poisoning mortality rates","volume":"53","author":"Ruhm","year":"2017","journal-title":"Am J Prev Med"},{"key":"2024102101265264000_55.6.1901344.3","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMp1402780"},{"key":"2024102101265264000_55.6.1901344.4","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMp1011512"},{"key":"2024102101265264000_55.6.1901344.5","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm6450a3"},{"key":"2024102101265264000_55.6.1901344.6","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm655051e1"},{"key":"2024102101265264000_55.6.1901344.7","first-page":"1","article-title":"Drug poisoning deaths in the United States, 1980\u20132008","volume":"81","author":"Warner","year":"2011","journal-title":"NCHS Data Brief"},{"key":"2024102101265264000_55.6.1901344.8","unstructured":"Schiller EY , Mechanic OJ . 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