Is Sleep-Disordered Breathing a Major Cause of Sleep Disturbances in Methadone-Maintained Patients?
More than 75% of opioid-dependent patients receiving methadone report sleep problems. In this cross-sectional investigation, researchers sought to determine the prevalence of sleep-disordered breathing (SDB), including central and obstructive sleep apnea (CSA and OSA, respectively), in methadone-maintained patients who report sleep disturbances and also examined the association between SDB, sleep-complaint severity, methadone dose, and illicit substance use. Eligible participants (N=71) had subjective sleep complaints as defined by a validated measure. Patients with psychotic or bipolar disorders, recent trazodone use, unstable housing, chronic medical illness, or <3 months of stable methadone dose were excluded. Sleep and respirations were measured via portable polysomnography.
- Thirty participants (42%) had SDB; of these, 20 met criteria for OSA, 5 for CSA, and 5 for both OSA and CSA.
- Sleep disturbances included decreased sleep efficiency, decreased REM sleep, and increased stage-2 sleep. These did not differ among participants with and without SDB.
- Neither OSA nor CSA was associated with severity of sleep complaints.
- CSA was not associated with methadone dose or benzodiazepine use.
- Patients with SDB had received methadone for a significantly longer period of time than those without.