Opioids and sleep

Cutrufello, Nicholas J.; Ianus, Vlad; Rowley, James A.

doi:10.1097/mcp.0000000000000733

Cited by 18 publications

(8 citation statements)

References 40 publications

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“…The parabrachial complex controls the breathing rate and helps maintain upper airway muscle tone via sleep-related chemosensory regulation (Damasceno et al, 2014). Exogenous opioids modulate parabrachial complex function during sleep, both by binding directly to mu-opioid receptors and interacting with chemosensory neurons (Cutrufello et al, 2020). Importantly, chemoreceptors, located on the dendrites of chemosensory neurons within the carotid body (Wicher & Marion-Poll, 2018), are integral to the detection of hypoxia and altered breathing during NREM sleep (Skatrud & Dempsey, 1983).…”

Section: Opioid Use and Sleep Apneamentioning

confidence: 99%

“…For example, acute opioid administration reduces neural activity and GABA neurotransmission in the pontine reticular formation, an area of the brainstem involved in sleep and eye movement (Cronin et al, 1995; Watson et al, 2007), and disrupts sleep architecture by reducing REM sleep in rodent models (Gauthier et al, 2011). In humans, acute opioid administration also disrupts sleep architecture by reducing time spent in stage N3, also referred to as slow-wave sleep (Dimsdale et al, 2007), although acute opioid use may increase total sleep time for persons with acute pain (Cutrufello et al, 2020).…”

Section: Opioid Use and Objective Measures Of Sleepmentioning

confidence: 99%

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Sleep disturbance as a therapeutic target to improve opioid use disorder treatment.

Huhn¹,

Finan²

2022

Experimental and Clinical Psychopharmacology

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Sleep health is an important factor across several physical and mental health disorders, and a growing scientific consensus has identified sleep as a critical component of opioid use disorder (OUD), both in the active disease state and during OUD recovery. The goal of this narrative review is to collate the literature on sleep, opioid use, and OUD as a means of identifying therapeutic targets to improve OUD treatment outcomes. Sleep disturbance is common and often severe in persons with OUD, especially during opioid withdrawal, but also in persons on opioid maintenance therapies. There is ample evidence that sleep disturbances including reduced total sleep time, disrupted sleep continuity, and poor sleep quality often accompany negative OUD treatment outcomes. Sleep disturbances are bidirectionally associated with several other factors related to negative treatment outcomes, including chronic stress, stress reactivity, low positive affect, high negative affect, chronic pain, and drug craving. This constellation of outcome variables represents a more comprehensive appraisal of the quality of life and quality of recovery than is typically assessed in OUD clinical trials. To date, there are very few clinical trials or experimental studies aimed at improving sleep health in OUD patients, either as a means of improving stress, affect, and craving outcomes, or as a potential mechanistic target to reduce opioid withdrawal and drug use behaviors. As such, the direct impact of sleep improvement in OUD patients is largely unknown, yet mechanistic and clinical research suggests that therapeutic interventions that target sleep are a promising avenue to improve OUD treatment. Public Significance StatementIn light of the ongoing opioid crisis, there is a pressing need to improve treatment outcomes for opioid use disorder. Sleep disturbance is a common complaint among persons with opioid use disorder, and interventions that target sleep in this population could improve stress, affect, craving, and/or relapse outcomes.

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Section: Opioid Use and Sleep Apneamentioning

confidence: 99%

Section: Opioid Use and Objective Measures Of Sleepmentioning

confidence: 99%

Sleep disturbance as a therapeutic target to improve opioid use disorder treatment.

Huhn¹,

Finan²

2022

Experimental and Clinical Psychopharmacology

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“…Sleep disorders are common among patients taking opioids, including obstructive sleep apnea (OSA), central sleep apnea (CSA), insomnia, inappropriate sleep duration, and poor sleep quality. [58][59][60] The flow chart in Figure 1 provides an outline of the process clinicians could consider in the sleep evaluation of patients with OUD. After an initial screening, patients may need objective testing with a sleep study including polysomnography.…”

Section: Discussionmentioning

confidence: 99%

Poor Sleep Quality and Other Risk Factors for Unemployment Among Patients on Opioid Agonist Treatment

et al. 2022

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Purpose: Patients with opioid use disorder (OUD) face high rates of unemployment, putting them at higher risk of treatment nonadherence and poor outcomes, including overdose death. The objective of this study was to investigate sleep quality and its association with other biopsychosocial risk factors for unemployment in patients receiving opioid agonist treatment (OAT) for OUD. Methods: Using a cross-sectional survey design, participants from 3 OAT programs for OUD completed questionnaires to measure sleep quality (Pittsburgh Sleep Quality Index [PSQI]); pain disability; catastrophic thinking; injustice experience; quality of life; and self-assessed disability. Spearman’s rank correlation was used to test for associations between sleep quality and other study variables. Results: Thirty-eight participants completed the study, with mean age 45.6 ± 10.9 years, 27 (71.1%) males, and 16 (42.1%) reporting a high school diploma/equivalent certification as the highest level of academic attainment. Poor sleep quality (defined as PSQI > 5) was identified in 29 participants (76.3%) and was positively correlated with pain disability ( r = 0.657, P < .01), self-assessed disability ( r = 0.640, P < .001), symptom catastrophizing ( r = 0.499, P < .001), and injustice experience ( r = 0.642, P < .001), and negatively correlated with quality of life ( r = −0.623, P < .001). Conclusions: There was a high prevalence of poor sleep quality in patients with OUD on OAT and this was associated with multiple known risk factors for unemployment. These findings warrant the consideration of regular screening for sleep problems and the inclusion of sleep-related interventions to improve sleep quality, decrease the unemployment rate, and enhance the recovery process for individuals with OUD undergoing OAT.

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“…Many prescribed medications can have an impact on sleep and circadian rhythm. Sedative drugs, such as hypnotics and anxiolytics, as well as opioids, are associated with daytime somnolence, disruption of the circadian rhythm due to daytime napping, and decreased SWS and REM sleep [81,82]. Anticonvulsants and antihistamines are other sedating drugs that could increase daytime somnolence [83,84], and H2 receptor antagonists can be also sedating [42,85].…”

Section: Intrinsic Factormentioning

confidence: 99%

Disturbance of Sleep and Circadian Rhythm in Hospitalized Patients

Park

Kyong

2023

Chronobiol Med

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Sleep and circadian disturbance are common in hospitalized patients. Problems related to sleep induction, frequent awakening, poor sleep quality, and disturbed circadian rhythm including daytime somnolence and nighttime arousal are frequently observed in the hospital. Disturbance of sleep and circadian rhythm could interfere recovery of the patients, prolong the length of stay, and contribute to patient dissatisfaction. Various factors affect sleep and circadian rhythm disturbance in the hospital. Intrinsic factors are related to patients, including medical and psychiatric conditions, uncontrolled pain, prescribed medications, and physical inactivity. External factors related to the hospital environment such as noisy environment, excessive exposure to artificial light, inappropriate humidity, and temperature are also known interrupters for sleep. Medical care provided by professionals, including nighttime vital sign monitoring, phlebotomy, and medication administration, can also contribute to sleep and circadian rhythm disturbances. This review aims to systematically address sleep and circadian rhythm disturbances in hospitalized patients, discuss factors that affect sleep in the hospital, and suggest non-pharmacological and pharmacological treatment options.

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Opioids and sleep

Cited by 18 publications

References 40 publications

Sleep disturbance as a therapeutic target to improve opioid use disorder treatment.

Sleep disturbance as a therapeutic target to improve opioid use disorder treatment.

Poor Sleep Quality and Other Risk Factors for Unemployment Among Patients on Opioid Agonist Treatment

Disturbance of Sleep and Circadian Rhythm in Hospitalized Patients

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