Human sleep and EEG through a cycle of methadone dependence

Kay, David C.

doi:10.1016/0013-4694(75)90208-4

Cited by 67 publications

(25 citation statements)

References 17 publications

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“…A larger study of 50 MMT patients also documented less REM sleep in patients compared to controls, as well as increased Stage 2 sleep and decreased Stage 1 sleep, but did not demonstrate reductions in SWS (7). In older studies of sleep in patients taking methadone, Orr and Stahl (22) found an increase in Stage 1 percent and decrease in SWS percent and Kay (23) linked opiate use with increased REM latency. In our study of MMT patients, home PSG recordings documented abnormalities in similar sleep parameters compared to normal adults in this age range (20, 21), including lower total sleep time, lower REM sleep time, and higher wake after sleep onset.…”

Section: Discussionmentioning

confidence: 99%

Home Polysomnography in Methadone Maintenance Patients with Subjective Sleep Complaints

Sharkey

Kurth

Corso

et al. 2009

The American Journal of Drug and Alcohol Abuse

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Objective Most patients in methadone maintenance treatment (MMT) complain of poor sleep which is potentially linked to relapse, yet few studies have examined their sleep using polysomnography (PSG), and none to our knowledge have employed home PSG. Standard sleep laboratory research protocols often require two consecutive PSG nights because of inter-night variability in sleep attributed to first-night adaptation to a novel sleep environment and recording procedures. The purpose of this study was to assess the stability of sleep measures across two consecutive nights of home PSG in opioid-dependent MMT patients. Methods Home PSG was performed in 50 MMT patients with subjective sleep complaints. Participants were 54% female and 82% white with mean age = 36.8 years, median methadone dose = 100 mg/day, and median MMT duration = 286 days. Results Thirty-six participants completed two consecutive nights of at-home PSG and 14 completed one. For the former group, no differences in sleep measures were found across recordings. The one-night group had significantly less total sleep time, Stage 2 sleep, REM sleep, and shorter REM latency than the two-night group. Conclusions Home PSG is a viable method for recording sleep in opioid-dependent MMT patients, and was stable across consecutive nights of study. Two nights of home PSG for MMT patients, therefore, are not necessarily required and confidence in the reliability of data from one night of recording can be assumed. Excluding MMT research participants with only one PSG may exclude patients with the worst sleep – precisely the group that most warrants investigation.

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Section: Discussionmentioning

confidence: 99%

Home Polysomnography in Methadone Maintenance Patients with Subjective Sleep Complaints

Sharkey

Kurth

Corso

et al. 2009

The American Journal of Drug and Alcohol Abuse

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“…Research examining the effects of opioid medications on sleep architecture has demonstrated some common nocturnal abnormalities with a range of opiate drugs. For example, morphine, heroin, and methadone have been shown to result in a reduction in SWS and a suppression of REM sleep (Roubicek et al, 1969; Kay, 1975; Howe et al, 1980b; Howe et al, 1980a, 1981; Pickworth et al, 1981; Staedt et al, 1996; Dimsdale et al, 2007). Although the identification of diminished SWS and REM sleep during methadone treatment has been reported by several studies, data indicates that sleep architecture abnormalities are variable during periods of methadone treatment initiation, stabilization, and long-term maintenance (Kay, 1975).…”

Section: Introductionmentioning

confidence: 99%

“…A critical aspect of methadone maintenance is the relationship between treatment retention/duration and positive treatment outcomes (Condelli and Dunteman, 1993; Gottheil et al, 1993; Cacciola et al, 1998; Peles et al, 2008). Clinical data and practices stress the importance of methadone stabilization early in treatment related to a number of factors, such as physiological adjustment to methadone, stabilizing methadone dosing, and providing appropriate medical and social services (Kay, 1975; Brown et al, 1982; Hoffman and Moolchan, 1994; Eap et al, 2002; King and Brooner, 2008). Based upon a potentially greater physiological instability in patients early in methadone treatment, it was also hypothesized that the effects of methadone maintenance may be a function of treatment duration, in that MM participants who are early in treatment may exhibit a greater impact of SD on sleep homeostasis when compared to MM participants who have been in methadone treatment for more than a year.…”

Section: Introductionmentioning

confidence: 99%

Effects of sleep deprivation on sleep homeostasis and restoration during methadone-maintenance: A [31]P MRS brain imaging study

Trksak

Jensen

Plante

et al. 2010

Drug and Alcohol Dependence

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SUMMARYInsomnia afflicts many individuals, but particularly those in chronic methadone treatment. Studies examining sleep deprivation (SD) have begun to identify sleep restoration processes involving brain bioenergetics. The technique [31]P magnetic resonance spectroscopy (MRS) can measure brain changes in the high-energy phosphates: alpha-, beta-, and gamma-nucleoside triphosphate (NTP). In the present study, 21 methadone-maintained (MM) and 16 control participants underwent baseline (BL), SD (40 wakeful hrs), recovery1 (RE1), and recovery2 (RE2) study nights. Polysomnographic sleep was recorded each night and [31]P MRS brain scanning conducted each morning using a 4T MR scanner (dual-tuned proton/phosphorus headcoil). Interestingly, increases in total sleep time (TST) and sleep efficiency index (SEI) commonly associated with RE sleep were not apparent in MM participants. Analysis of methadone treatment duration revealed that the lack of RE sleep increases in TST and SEI were primarily exhibited by short-term MM participants (methadone<12 months), while RE sleep in long-term MM (methadone>12 months) participants was more comparable to control participants. Slow wave sleep increased during RE1, but there was no difference between MM and control participants. Spectral power analysis revealed that compared to control participants; MM participants had greater delta, theta, and alpha spectral power during BL and RE sleep.[31]P MRS revealed that elevations in brain beta-NTP (a direct measure of ATP) following RE sleep were greater in MM compared to control participants. Results suggest that differences in sleep and brain chemistry during RE in MM participants may be reflective of a disruption in homeostatic sleep function.

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“…Persistence, although attenuated, of this arousal effect is seen during chronic administration of morphine (Kay, 1975b). Methadone produces a comparable dose-related insomnia in nondependent opiate addicts (Pickworth, Neidert & Kay, 1981), with almost complete tolerance developing during chronic administration of methadone (Kay, 1975a). Heroin (diacetylmorphine) effects on sleep have not been studied as extensively as those of morphine or methadone.…”

Section: Introductionmentioning

confidence: 99%

Morphine‐like insomnia from heroin in nondependent human addicts.

Dc¹,

Pickworth²,

Neider³

1981

Brit J Clinical Pharma

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1 This study was performed because dose-related effects of heroin on human sleep had not been described previously, and to discover if heroin produces a morphine-like insomnia. 2 After three adaptation nights, the sleep of seven male nondependent opiate addicts was studied following i.m. doses of heroin (3, 6, 12 mg/70 kg), morphine (10, 20 mg/70 kg) or placebo at weekly intervals in a randomized double-blind crossover design. 3 Heroin produces a dose-related increase in wakefulness, drowsiness episodes, muscle tension, and shifts in sleep-waking states.I 4 Heroin produces a dose-related decrease in total sleep, sleep efficiency, delta sleep and REM sleep (REMS). 5 Heroin is about twice as potent as morphine in producing this type of insomnia. 6 'Morphine insomnia' appears to be a characteristic initial effect of several opioids, at least in nondependent opiate addicts, and might serve as a model insomnia for evaluation of hypnotics.

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Human sleep and EEG through a cycle of methadone dependence

Cited by 67 publications

References 17 publications

Home Polysomnography in Methadone Maintenance Patients with Subjective Sleep Complaints

Home Polysomnography in Methadone Maintenance Patients with Subjective Sleep Complaints

Effects of sleep deprivation on sleep homeostasis and restoration during methadone-maintenance: A [31]P MRS brain imaging study

Morphine‐like insomnia from heroin in nondependent human addicts.

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