Sleep problems reported by patients entering opioid agonist treatment

Burke, Christopher K.; Peirce, Jessica M.; Kidorf, Michael; Neubauer, David N.; Punjabi, Naresh M.; Stoller, Kenneth B.; Hursh, Steve; Brooner, Robert K.

doi:10.1016/j.jsat.2007.10.003

Cited by 47 publications

(36 citation statements)

References 35 publications

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“…Our respondents confirmed that substance use undermines sleep quality and quantity (Arnedt et al, 2012;Burke et al, 2008;Escobar-Cordoba et al, 2009;Hasler et al, 2014), but also revealed that poor sleep can persist even after substance use has reduced or ceased. The types of sleep problems identified were diverse; as were accounts of the causes of, and strategies for dealing with, those problems.…”

Section: Discussionsupporting

confidence: 69%

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Substance use, sleep and intervention design: insights from qualitative data

Neale

Meadows

Nettleton

et al. 2017

Journal of Mental Health

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Background: Alcohol and other drug use is associated with poor sleep quality and quantity, but there is limited qualitative research exploring substance users' experiences of sleep and few psychosocial sleep interventions for them. Aim: To inform the development of psychosocial interventions to improve sleep amongst people reporting drug/alcohol problems. Method: Qualitative data were collected during a sleep survey. Of the 549 drug/alcohol users completing the survey, 188 (34%) provided additional information about their sleep using a free text box. Responses were analysed via Iterative Categorisation. Findings were reviewed with reference to the Behaviour Change Wheel (BCW). Results: All data were categorised inductively under five headings: (i) sleep quality; (ii) nature of sleep problems; (iii) sleep and substances; (iv) factors improving sleep quality; (v) factors undermining sleep quality. Substance use undermined sleep, but poor sleep often persisted after substance use had ceased. Sleep problems were diverse; as were the causes of, and strategies for dealing with, those problems. Causes and strategies had biological, psychological, social and environmental roots. Conclusions: The BCW facilitated the identification of intervention components that might improve the sleep of people who use substances. These components relate to education, training, enablement, modelling, service provision, guidelines and environment.

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Section: Discussionsupporting

confidence: 69%

“…Illicit and non-medical psychoactive substance use is linked to poor sleep quality and quantity (Arnedt et al, 2012;Burke et al, 2008;Escobar-Cordoba et al, 2009;Hasler et al, 2014). Nonetheless, there is limited qualitative research on substance users' subjective experiences of sleep.…”

Section: Introductionmentioning

confidence: 99%

Substance use, sleep and intervention design: insights from qualitative data

Neale

Meadows

Nettleton

et al. 2017

Journal of Mental Health

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“…Similarly, PO dependent individuals exhibited self-reported sleep disturbance (assessed by the PSQI) and sub-threshold insomnia (assessed by the ISI) that were approximately 10 and 4.5 times higher, respectively, than controls. In accordance with these findings, prior research has documented deficits in sleep functioning among other opioid dependent populations, including individuals entering methadone maintenance treatment (Dyer & White, 1997; Puigdollers et al, 2004; Sharkey et al, 2011; Wang et al, 2005), treatment seeking heroin dependent individuals (Burke et al, 2008), and recipients of long-term opioid agonist therapy (Stein et al, 2004; Peles et al, 2006). The importance of continued investigation of the effects of PO dependence on sleep are underscored by data suggesting that the effects of opioids on sleep may be greater than that of other substances of abuse (Casola et al, 2006), and that sleep architecture is negatively affected during each stage of opioid dependence: induction, maintenance, acute abstinence, and protracted abstinence (for review see Wang and Teichtahl, 2007).…”

Section: Discussionmentioning

confidence: 52%

“…These findings are consistent with literature demonstrating significant interrelations between chronic pain conditions, sleep disruption, and PO dependence (Onen et al, 2005). Of note, a substantial proportion of opioid dependent individuals report regulation of sleep as a significant motivator for use (Burke et al, 2008; McCabe et al, 2009; Rigg & Ibanez, 2010). Conversely, neurobiological research indicates that use of exogenous opioids that block endogenous opioid peptide receptors are also active in the regulation of sleep, thereby impacting sleep architecture and contributing to increased latency of sleep onset, decreased REM sleep, increased waking bouts, and greater sleep fragmentation (Aghajanian, 1978; Dimsdale et al, 2007; Lord et al, 1977; Wang & Teichtahl, 2007).…”

Section: Discussionmentioning

confidence: 99%

Sleep disturbances and pain among individuals with prescription opioid dependence

Hartwell

Pfeifer

McCauley

et al. 2014

Addictive Behaviors

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BACKGROUND Poor sleep quality has been observed in individuals with substance use disorders and is often a trigger for relapse. To date, little research has investigated sleep quality among individuals with prescription opioid (PO) dependence. The present study aimed to address this gap in the literature by examining subjective and objective sleep disturbances among PO dependent individuals. METHODS Subjects were 68 non-treatment seeking individuals (33 PO dependent, 35 healthy controls). Subjective sleep was assessed with the Pittsburgh Sleep Quality Index (PSQI) and Insomnia Severity Index (ISI). Subjects were admitted for an overnight inpatient hospital stay during which objective sleep data was collected using an actigraphy device. Self-report pain was measured with the Brief Pain Inventory. RESULTS Significant group differences in subjective sleep quality were revealed in the PSQI (p<0.01) and ISI (p<0.01). Poor sleep quality (i.e., PSQI total score > 5) was identified in 80.6% of the PO group, as compared to 8.8% of the control group (p<.001). Significant group differences in sleep quality were identified in five of six actigraphy variables: total time asleep, sleep efficiency, latency of onset of sleep, total time awake and time mobile. Furthermore, significant associations between pain severity and sleep quality were observed. CONCLUSIONS Results indicate high rates of sleep impairment and poor sleep quality among PO dependent individuals. Pain severity was significantly correlated with sleep quality. Although preliminary, the findings highlight the importance of assessing and treating sleep disturbances, as well as pain, among patients with PO dependence.

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“…Like chronic users of other substances including alcohol, opiates, and cannabis, [7][8][9][10][11][12][13][14][15] chronic cocaine users have severely disrupted sleep 16,17 that may persist for weeks, months, or even longer (for review, see Angarita et al 18 ). Over the first several weeks of abstinence, polysomnographically (PSG) measured sleep in chronic cocaine users worsens, with shortening total sleep time, diminishing REM sleep (rapid eye movement sleep; a sleep phase characterized by rapid and random eye movements, muscle inhibition, and brain waves similar to those exhibited during wakefulness) time, increasing sleep latency, and chronically decreased slow-wave sleep time.…”

Section: Introductionmentioning

confidence: 99%

Sleep Perception and Misperception in Chronic Cocaine Users During Abstinence

Hodges

Pittman

Morgan

2016

Sleep

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Study Objectives: During abstinence, chronic cocaine users experience an objective worsening of sleep that is perceived as qualitatively improving. This phenomenon has been termed "occult insomnia." The objective of this study was to determine whether chronic cocaine users experience positive sleep state misperception during abstinence. Methods: Forty-three cocaine-dependent persons were admitted to an inpatient research facility for 12 days and 11 nights to participate in a treatment study of modafinil. Polysomnographic sleep recordings were performed on study nights 3, 4, 10, and 11, when participants were on average 1 and 2 weeks abstinent from cocaine. Participants also completed sleep diary questionnaires every evening before bed and every morning upon awakening. Polysomnographic and sleep diary measurements of total sleep time, sleep latency, time awake after sleep onset, and time in bed after final awakening were compared. Results: Chronic cocaine users accurately reported total sleep time after 1 week of abstinence but overreported total sleep time by an average of 40 min after 2 weeks of abstinence. Underestimating sleep latency and time spent awake after sleep onset were responsible for this difference. Conclusions: Positive sleep state misperception is revealed in chronic cocaine users after 2 weeks of abstinence and is consistent with the previously identified "occult insomnia" in this population.

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Sleep problems reported by patients entering opioid agonist treatment

Cited by 47 publications

References 35 publications

Substance use, sleep and intervention design: insights from qualitative data

Substance use, sleep and intervention design: insights from qualitative data

Sleep disturbances and pain among individuals with prescription opioid dependence

Sleep Perception and Misperception in Chronic Cocaine Users During Abstinence

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