Abstract
Methadone maintenance therapy is an effective treatment for opiate dependence, but more than three-quarters of persons receiving the treatment report sleep quality disturbances. In this double-blind, randomized, controlled trial, we recruited 90 individuals receiving methadone for at least one month who reported sleep disturbances and had Pittsburgh Sleep Quality Index (PSQI) scores > 5. The purpose of this study was to determine whether Suan Zao Ren Tang, one of the most commonly prescribed traditional Chinese medications for treatment of insomnia, improves subjective sleep among methadone-maintained persons with disturbed sleep quality. Ninety patients were randomly assigned to intervention group (n = 45) and placebo group (n = 45), and all participants were analyzed. Compared with placebo treatment, Suan Zao Ren Tang treatment for four weeks produced a statistically significant improvement in the mean total PSQI scores (P = 0.007) and average sleep efficiency (P = 0.017). All adverse events (e.g., lethargy, diarrhea, and dizziness) were mild in severity. Suan Zao Ren Tang is effective for improving sleep quality and sleep efficiency among methadone-maintained patients with sleep complaints.
Highlights
Heroin dependence is one of the chronic medical illnesses and a public health problem worldwide
Other studies have reported that 84% of methadone-maintained patients have Pittsburgh Sleep Quality Index (PSQI) scores ≥ 6 [10], whereas another study found that only 35.2% of the general population had PSQI scores > 5 [14]
In one study of 71 obstructive sleep apnea (OSA) and central sleep apnea (CSA) patients who were in methadone maintenance therapy (MMT) at least 3 months, the results showed that CSA was not associated with methadone doses and OSA was more common than CSA in this population
Summary
Heroin dependence is one of the chronic medical illnesses and a public health problem worldwide. More than three-quarters of persons receiving MMT report sleep quality disturbances [8,9,10]. The severity of sleep symptoms has been associated with comorbid psychiatric disorders, chronic pain, lower levels of daily functioning, and the use of other drugs [9,10,11]. Methadone-maintained patients with sleep disturbances receive, on average, fewer than six hours of sleep daily [12]. Other studies have reported that 84% of methadone-maintained patients have PSQI scores ≥ 6 [10], whereas another study found that only 35.2% of the general population had PSQI scores > 5 [14]. The incidence of sleep disturbances among methadone-maintained patients is significantly higher than that for the general population. Two polysomnographic studies show reduction of rapid eye movement (REM) sleep and slow wave sleep during induction and maintenance of opioid use [17, 18]
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