Article Text

Download PDFPDF

Simple screening model for identifying the risk of sleep apnea in patients on opioids for chronic pain: an infographic
  1. Rajnish K Gupta1 and
  2. Eric S Schwenk2
  1. 1 Anesthesiology, Vanderbilt University Medical Center, Nashville, Tennessee, USA
  2. 2 Anesthesiology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
  1. Correspondence to Dr Rajnish K Gupta, Anesthesiology, Vanderbilt University Medical Center, Nashville, Tennessee, USA; raj.gupta{at}

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


Chronic pain patients taking opioids are at higher risk for obstructive sleep apnea (OSA) than the general population. Fifty million people in the USA have chronic pain and 20% of these patients are on opioids. Of these chronic pain patients on opioids, 59% had undiagnosed sleep apnea and 30.8% of these had severe OSA. A simple OSA screen using the STOP-Bang Questionnaire and resting daytime SpO2 in the clinic can be very sensitive at detecting undiagnosed OSA. Those patients can be sent for definitive polysomnography (sleep study). However, this simple standard screening evaluation is not very specific and many patients without OSA end up receiving a sleep study that is expensive, time consuming and has limited availability. Selvanathan et al propose an additional step to the screening model by adding a home oxygen desaturation test.1 With this additional tool, the authors were able to rule out OSA for nearly 38% more patients than by just doing the STOP-Bang Questionnaire or resting oxygen saturation alone. The addition of home oximetry to detect oxygen desaturation events is a simple and effective way to screen for OSA in this high-risk population while reducing the number of patients without OSA who needed to undergo a sleep study.

Ethics statements

Patient consent for publication


The authors would like to acknowledge Jim Snively, artist, of Pittsburgh, Pennsylvania, for creation of this infographic.



  • Twitter @dr_rajgupta, @ESchwenkMD

  • Contributors Both authors contributed to the content and editing of the infographic.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests Both authors are associate editors for Regional Anesthesia and Pain Medicine. RKG is a board member of the American Society of Regional Anesthesia and Pain Medicine.

  • Provenance and peer review Commissioned; internally peer reviewed.

Linked Articles