0235 A Systematic Review of Sleep Health and Outpatient Opioid Use Disorder Treatment in Adults

Abstract

Abstract Introduction Opioid Use Disorder (OUD) affects 2 million people in the United States and poor sleep health (satisfaction, alertness, timing, efficiency, and duration) is a primary driver of medication-assisted treatment (MAT) failure and relapse. It is known that people in therapy for OUD have a high prevalence of sleep problems (>75%) and poorer sleep health compared to people without OUD (e.g., lower sleep efficiency, shorter duration, and more awakenings). However, sleep health is not routinely assessed. Thus, in this systematic review, we examined original studies on sleep health within the context of adults receiving outpatient MAT for OUD. Methods We conducted a systematic review of original research on sleep health in adults receiving outpatient treatment for OUD. Multiple electronic databases (PubMed, PsycINFO, and CINAHL) were searched for relevant studies published in English from the establishment of each database to September 14, 2021. Quality was assessed with the Mixed Methods Appraisal Tool (v. 2001). Results Sixty two studies were selected including 17,913 adults with OUD and 604 comparison participants without OUD (mean age = 37.4 ± 6.6 years; 54.1% male). Sixty-one studies were quantitative (50 cross sectional, 6 longitunal, 5 interventional) and 1 was mixed methods. Participants with OUD had poorer satisfaction (Pittsburgh Sleep Quality Index mean 7.4 ± 2.2 v. 4.7 ± 2.3), shorter polysomnography (PSG) measured total sleep time (336.6 ± 41.4 mins (5.6 h) v. 411.8 ± 33.3 mins (6.8 h), spent less time in PSG measured slow wave N3 sleep (7.2 ± 5.8% v. 13.4 ± 6.4%), and had a lower percentage of PSG measured rapid eye movement sleep (14.6 ± 4.6% v. 21.7 ± 4.0%) than comparison participants without OUD. Conclusion Studies were predominantly observational ranging from a period of 1-2 nights to 2 years with participants at various points in treatment. More work is needed to understand the multidimensional depth of sleep health in adults with OUD. Optimizing sleep health in adults with OUD may improve their addiction trajectory and should be a priority in practice and research. Support (If Any) American Academy of Sleep Medicine (220-BS-19).