312 Chapter 10 Twenty occasions of opioid use in 16 people were reported. Individual patient characteristics and opioid use-related narcolepsy symptom effects are reported in Table 3. Used opioids included codeine (seven times), tramadol (six times), oxycodone (six times), fentanyl (once). Treatment indications were respiratory complaints (five times), back pain/spinal hernia (four times), leg surgery (three times), shoulder pain (twice), tooth removal/pain (twice), lung cancer (once), generalised muscle/joint pain (once), disturbed nocturnal sleep (once) and recreational use (once). Duration of use ranged from days to multiple months or years (median duration of use, range: 14 days, one daymultiple years). Narcolepsy symptom severity changes were seen in 11/20 uses (95% CI [32%, 76%]) with nine positive (95% CI [24%, 68%]), one mixed (95% CI [0%, 27%]) and one negative report (95% CI [0%, 27%]). Positive effects of opioid use on disturbed nocturnal sleep (9/20), excessive daytime sleepiness (4/20), hypnagogic hallucinations (3/17), cataplexy (2/18), and sleep paralysis (1/13) were reported. Effects were most pronounced in people who took oxycodone (4/6 reported positive effects). Moderate positive effects were seen in people who took codeine where 4/7 reported positive effects. Within the interview, multiple people reported that it was easier for them to sleep through the night as they had fewer awakenings when taking the opioid. Fewer potential cataplexy triggers were also encountered by some respondents because of the indication for which they were taking the opioid. All respondents who had narcolepsy symptom severity changes reported that the effect waned within days when the opioid was discontinued.
RkJQdWJsaXNoZXIy MjY0ODMw