Opioid Effects on Computer-Derived Sleep and EEG Parameters in Nondependent Human Addicts

Kay, David C.; Pickworth, Wallace B.; Neidert, Gary L.; Falcone, David; Fishman, P.; Othmer, Ekkehard

doi:10.1093/sleep/2.2.175

Cited by 50 publications

(23 citation statements)

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“…Finally, our measurement of NREM sleep is subject to potential bias as application of low doses of opioids has been shown to affect sleep behavior and decreases Non-REM sleep and rapid eye movement sleep as measured by EEG and sleep efficiency in rodents 62,63 and humans 64 . In contrast, high doses of morphine induce sedation and are associated with slowing of the EEG 65–68 , in part mediated by central opioid inputs to sleep regulating brain areas (e.g.…”

Section: Discussionmentioning

confidence: 99%

Continuous Positive Airway Pressure Mitigates Opioid-induced Worsening of Sleep-disordered Breathing Early after Bariatric Surgery

et al. 2016

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Background Bariatric surgery patients are vulnerable to sleep-disordered breathing (SDB) early after recovery from surgery and anesthesia. The authors hypothesized that continuous positive airway pressure (CPAP) improves postoperative oxygenation and SDB and mitigates opioid-induced respiratory depression. Methods In a randomized crossover trial, patients after bariatric surgery received 30% oxygen in the postanesthesia care unit (PACU) under two conditions: atmospheric pressure and CPAP (8 to 10 cm H2O). During 1 h of each treatment, breathing across cortical arousal states was analyzed using polysomnography and spirometry. Arousal state and respiratory events were scored in accordance with American Academy of Sleep Medicine guidelines. Data on opioid boluses in the PACU were collected. The primary and secondary outcomes were the apnea hypopnea index (AHI) and apnea after self-administration of opioids in the PACU. Linear mixed model analysis was used to compare physiologic measures of breathing. Results Sixty-four percent of the 33 patients with complete postoperative polysomnography data demonstrated SDB (AHI greater than 5/h) early after recovery from anesthesia. CPAP treatment decreased AHI (8 ± 2/h vs. 25 ± 5/h, P < 0.001), decreased oxygen desaturations (5 ± 10/h vs. 16 ± 20/h, P < 0.001), and increased the mean oxygen saturation by 3% (P = 0.003). CPAP significantly decreased the respiratory-depressant effects observed during wakefulness–sleep transitions without affecting hemodynamics. The interaction effects between CPAP treatment and opioid dose for the dependent variables AHI (P < 0.001), inspiratory flow (P = 0.002), and minute ventilation (P = 0.015) were significant. Conclusions This pharmacophysiologic interaction trial shows that supervised CPAP treatment early after surgery improves SDB and ameliorates the respiratory-depressant effects of opioids without undue hemodynamic effects.

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Section: Discussionmentioning

confidence: 99%

Continuous Positive Airway Pressure Mitigates Opioid-induced Worsening of Sleep-disordered Breathing Early after Bariatric Surgery

et al. 2016

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“…A Grass 78 polygraph was used to record several parameters from each subject: two measures of the electroencephalograph (EEG), P3-A2 (mastoid process) and Fz-Oz; two measures of the electro-oculograph (EOG), between each lateral epicanthus and A2; the submental electromyograph (EMG); the respiratory pattern, detected by transthoracic impedance; and the finger plethysmograph response (FPR), detected by indirect light reflectance from an index finger. Computer analyses from tape recordings of some of these data are reported elsewhere (Kay, Pickworth, Neidert, Falcone, Fishman & Othmer, 1979).…”

Section: Methodsmentioning

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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“…Other opioids (eg, heroin and methadone) were reported to produce dose-related arousal (increase in waking state and decrease in REM sleep) in prisoners with a history of, but not current, opiate abuse. 2 The effects are not limited to opiate abusers, since tramadol produced dose-related disturbed sleep in a randomized crossover trial in healthy volunteers 3 and morphine reduced slow-wave sleep in healthy adults 4,5 (but produced an only moderate or nonsignificant reduction in REM without arousal in healthy, pain-free young adults). Likewise, intrauterine exposure of fetal lambs to low-dose morphine resulted in a state of arousal with loss of quiet sleep and of REM stage 1122 I The Annals of Pharmacotherapy I 2012 July/August, Volume 46 theannals.com sleep (tolerance developed to these effects by day 3 of continuous exposure).…”

Section: Is Morphine Medicine's Biggest Misnomer?mentioning

confidence: 99%

Is Morphine Medicine's Biggest Misnomer?

Raffa

Pergolizzi

2012

Ann Pharmacother

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REFERENCES1. Goldstein EJ, Citron DM, Peraino V, Elgourt T, Meibohm AR, Lu S. Introduction of ertapenem into a hospital formulary: effect on antimicrobial usage and improved in vitro susceptibility of Pseudomonas aeruginosa. 2. Eagye KJ, Nicolau DP. Absence of association between use of ertapenem and change in antipseudomonal carbapenem susceptibility rates in 25 hospitals. Infect Control Hosp Epidemiol 2010;31:485-90. 3. Goff DA, Mangino JE. Ertapenem: no effect on aerobic gram-negative susceptibilities to imipenem.

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Opioid Effects on Computer-Derived Sleep and EEG Parameters in Nondependent Human Addicts

Cited by 50 publications

References 0 publications

Continuous Positive Airway Pressure Mitigates Opioid-induced Worsening of Sleep-disordered Breathing Early after Bariatric Surgery

Continuous Positive Airway Pressure Mitigates Opioid-induced Worsening of Sleep-disordered Breathing Early after Bariatric Surgery

Morphine‐like insomnia from heroin in nondependent human addicts.

Is Morphine Medicine's Biggest Misnomer?

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