Background: Opioids are among the most commonly prescribed medications for chronic pain. However, sleep architecture is negatively impacted by these drugs and the long-term effects of opioids on sleep quality are unknown. We hypothesized that opioid-naïve participants would have better sleep quality than both current and previous chronic users of opioids. We also sought to explore whether methadone and buprenorphine have differing effects on sleep quality, and whether amount of time since abstaining from opioids is associated with sleep quality.
Method: Participants were 120 people with chronic pain (84.2% Caucasian, Mage = 42.0 years, SD = 11.44). They were in one of four groups of 30 participants each: 1) current users of methadone for opioid use disorder (OUD); 2) current users of buprenorphine for OUD; 3) a history of medication-assisted therapy for OUD but currently opioid-abstinent for at least 6 months; 4) those who took less than one month of lifetime cumulative opioids. Participants completed the Pittsburgh Sleep Quality Index (PSQI) and the Short Form Health Survey (SF-36).
Results: The sleep quality, sleep duration, sleep disturbances, and daytime dysfunction subscales of the PSQI were analyzed as outcomes in a MANCOVA to assess differences amongst the four groups, controlling for use of sleep medications. The chronic pain groups were significantly different on the combined dependent variables after controlling for sleep medications, F(12, 297) = 4.193, p < .001, Wilks' Λ = 0.661, partial η2 = 0.129. Groups one, two, and three all differed significantly from the control group (all p < .05). A Pearson’s correlation revealed a significant relationship between weeks since abstaining from opioids and sleep disturbances in the opioid-abstinent group (r = -0.604, p < .001).
Discussion: The results of this study suggest that opioids interfere with sleep quality, even after months of abstention. Thus, clinicians should be aware that opioids’ interference with sleep problems in this population may persist even throughout sobriety. Additional study of the long-term effects of opioids is warranted and may further highlight the importance of addressing sleep problems in this population.
|Commitee:||Shaffer, Jonathan, Edinger, Jack|
|School:||University of Colorado at Denver|
|Department:||Clinical Health Psychology|
|School Location:||United States -- Colorado|
|Source:||MAI 81/8(E), Masters Abstracts International|
|Subjects:||Psychology, Behavioral psychology|
|Keywords:||Addiction, Buprenorphine, Chronic pain, Methadone, Opioids, Sleep|
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