A prospective, longitudinal study of sleep disturbance and comorbidity in opiate dependence (the ANRS Methaville study)

Nordmann, Sandra; Lions, C.; Vilotitch, Antoine; Laurent, Michel; Mora, Marion; Spire, Bruno; Maradan, Gwenaëlle; Morel, Alain; Roux, Perrine; Carrieri, Patrizia

doi:10.1007/s00213-016-4202-4

Cited by 28 publications

(15 citation statements)

References 67 publications

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“…Moreover, several studies have reported a significant association between smoking and sleep problems, 49 , 50 and a prospective study also reported that opioid-dependent patients with severe nicotine dependence had a higher risk of severe sleep disturbance. 51 However, the present study did not find a significant association between nicotine use and CPSD. Further studies focusing on heroin users receiving MMT are needed to explore the association between nicotine use and sleep disturbance.…”

Section: Discussioncontrasting

confidence: 92%

Predictors of sleep disturbance in heroin users receiving methadone maintenance therapy: a naturalistic study in Taiwan

Li¹,

Chung²,

Wu³

et al. 2018

NDT

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IntroductionSleep disturbance is a major health concern for heroin users receiving methadone maintenance treatment (MMT). The present study was aimed to investigate the predictors for new-onset clinically predominant sleep disturbance (CPSD) among heroin users receiving MMT.MethodsThis 2-year retrospective study included 152 individuals (127 males and 25 females) with heroin use disorder who visited our MMT clinics for the first time. A univariate Cox proportional hazards regression model (Cox model) was used to estimate the potential factors of subsequent CPSD, followed by a multivariate Cox model to identify significant predictors of CPSD after adjusting for other covariates.ResultsTwenty-nine (19.1%) participants developed CPSD during the 2-year period. After forward selection in the Cox model, earlier age at onset of heroin exposure (OR=0.95; P=0.044), lower attendance rate (OR =0.04; P=0.03), greater maximum dose of methadone (OR =1.01; P=0.022), and shorter time to maximum methadone dose (OR =0.98; P=0.007) were significantly associated with new-onset CPSD.ConclusionWe identified predictors that were significantly associated with new-onset CPSD, and clinicians should be aware of sleep disturbance in heroin users receiving MMT with these risk factors. Future studies are necessary to verify our findings and extend the applicability.

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Section: Discussioncontrasting

confidence: 92%

Predictors of sleep disturbance in heroin users receiving methadone maintenance therapy: a naturalistic study in Taiwan

Li¹,

Chung²,

Wu³

et al. 2018

NDT

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“…Third, sleep disorders could mediate the relationship between pain and suicide attempt/ideation. Although not observed in the present study, the association between sleep disorders and pain and suicide risk was highlighted in a previous study using Methaville trial data [46]. Fourth, physical pain could lead to suicide attempt/ideation through its interaction with social pain (hopelessness, loss of work and changing family role, as well as isolation due to pain), as both types of pain may share some underlying neurological mechanisms [47].…”

Section: Discussionmentioning

confidence: 53%

Pain in methadone patients: Time to address undertreatment and suicide risk (ANRS-Methaville trial)

et al. 2017

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BackgroundPain in opioid-dependent patients is common but data measuring the course of pain (and its correlates) using validated scales in patients initiating methadone treatment are sparse. We aimed to assess pain and its interference in daily life, associated correlates, and undertreatment before and during methadone treatment.MethodsThis is a secondary analysis using longitudinal data of a randomized trial comparing two methadone initiation models. We assessed the effect of methadone initiation and other correlates on pain intensity and interference (using the Brief Pain Inventory) at months 0, 6 and 12 using a mixed multinomial logistic regression model.ResultsThe study group comprised 168 patients who had data for either pain intensity or interference for at least one visit. Moderate to severe pain was reported in 12.9% of patients at M0, 5.4% at M6 and 7.3% at M12. Substantial interference with daily functioning was reported in 36.0% at M0, 14.5% at M6 and 17.1% at M12. Of the 98 visits where patients reported moderate to severe pain or substantial interference, 55.1% reported no treatment for pain relief, non-opioid analgesics were reported by 34.7%, opioid analgesics by 3.1% and both opioid and non-opioid analgesics by 7.1%. Methadone was associated with decreased pain intensity at 6 months (OR = 0.29, p = 0.04) and 12 months (OR = 0.30, p = 0.05) of follow-up and tended to be associated with substantial pain interference. Suicide risk was associated with both pain intensity and pain interference.ConclusionsMethadone in opioid-dependent patients can reduce pain. However, undertreatment of pain in methadone patients remains a major clinical concern. Patients with pain are at higher risk of suicide. Adequate screening and management of pain in this population is a priority and needs to be integrated into routine comprehensive care.

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“…Relative to healthy controls (8.8%), significantly more individuals with OUD (80.6%) have ratings ≥5 on the Pittsburgh Sleep Quality Index, indicative of poor sleep quality (Hartwell, Pfeifer, McCauley, Moran-Santa Maria, & Back, 2014), which has also been verified objectively through polysomnography (PSG) testing (Kay, Eisenstein, & Jasinski, 1969; Kay, 1975; Xiao et al, 2010). Sleep disturbance is evident among patients who are newly enrolled into OMT (Burke et al, 2008; Nordmann et al, 2016), as well as long-term OMT patients (Stein et al, 2004). Longitudinal evaluations suggest sleep does not naturally improve over the course of methadone treatment (Nordmann et al, 2016; Peles, Schreiber, Hamburger, & Adelson, 2011) and that sleep may in fact worsen, with the development of central sleep apnea in some patients (Wang et al, 2005).…”

Section: Introductionmentioning

confidence: 99%

Frequency and correlates of sleep disturbance in methadone and buprenorphine-maintained patients

Dunn

Finan

Tompkins

et al. 2018

Addictive Behaviors

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Results demonstrate substantial and clinically-significant impairments in sleep that are associated with a variety of current problems that could impact OMT outcomes and decrease quality of life. Outcomes support the development of methods to improve sleep in OMT patients, and to examine the degree to which sleep improvements may be associated with improvements in mood and other health-related measures.

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A prospective, longitudinal study of sleep disturbance and comorbidity in opiate dependence (the ANRS Methaville study)

Cited by 28 publications

References 67 publications

Predictors of sleep disturbance in heroin users receiving methadone maintenance therapy: a naturalistic study in Taiwan

Predictors of sleep disturbance in heroin users receiving methadone maintenance therapy: a naturalistic study in Taiwan

Pain in methadone patients: Time to address undertreatment and suicide risk (ANRS-Methaville trial)

Frequency and correlates of sleep disturbance in methadone and buprenorphine-maintained patients

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