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Sleep architecture in stable methadone patients

SLEEP ARCHITECTURE AND DAY TIME FUNCTION IN STABLE METHADONE MAINTENANCE TREATMENT PATIENTS

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David Wang1,3, Harry Teichtahl1,3, Olaf Drummer4, Cathy Goodman2, Gaye Cherry1, Andy Prodromidis2, David Cunnington1 & Ian Kronborg2
(1) Department of Respiratory & Sleep Disorders Medicine, and (2) Drug and Alcohol Service, Western Hospital (3) Department of Medicine (Royal Melbourne Hospital and Western Hospital), The University of Melbourne, Victoria, 3011. (4) Victorian Institute of Forensic Medicine, Victoria, 3006.

Methadone, a long acting mu-opioid agonist has been used as treatment for heroin addiction. Few studies have assessed the effects of chronic opiate use on sleep architecture and day-time function. The aim of the study was to compare stable methadone maintenance treatment (MMT) patients' sleep architecture and day-time function to that of normal subjects. Methods: 50 stable MMT patients (25M, 25F) and 20 age, sex and BMI matched control subjects (10M, 10F) were tested with two overnight polysomnography (the first being acclimatisation night). PSG were scored by blinded scorer and Rechtschaffen & Kales criteria were applied to stage the PSG. ESS and FOSQ were employed to test subjects' day-time function. Results: MMT patients have significant longer Stage 2 sleep (63.4±12.3% SD) and less REM sleep (14.9±7.1% SD) compared to normal subjects (55.3±8.7% and 18.3±4.6% respectively) (p=0.006; p=0.02). MMT patients have significantly shorter Stage 1 sleep (6.9±4.3% SD) than that of the control subjects (9.7±3.7%) (p=0.004). There was no significant difference between the two groups for total sleep time (MMT 378.9±55.9 SD min vs control 382.3±55.5 SD min, p=0.87), sleep latency, REM latency, sleep efficiency, SWS, arousal index and leg movements. MMT patients have significantly higher ESS (7.1±5.0 SD) and lower total FOSQ score (83.0±18.5 SD) than normal subjects (2.1±1.8; 113.6±6.1) (p<0.001; p<0.001). Conclusions: Stable MMT patients have more Stage 2 sleep and less REM and Stage 1 sleep compared to normal subjects. In addition, MMT patients have greater sleep propensity and poorer day-time function than controls.

Supported by: Australian Postgraduate Awards, Western Hospital Equipment, Education and Research Fund and Western Hospital Liver Research Fund.

Key words: Methadone, sleep architecture, day-time function, opioid.

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