Sleep Profile in Patients With Chronic Opioid Abuse

Abstract

Background Sleep disturbances occur in various stages of substance abuse, which might have a significant impact on the treatment success. Despite this fact, the number of researches studying sleep in substance abuse patients is relatively scarce. Objectives To study the profile of sleep in opioid abusers, after the period of detoxification, highlighting whether there is a remote effect of opioid abuse on sleep or not, exploring the nature of such sleep disturbances, if present. Methodology The case group comprised 33 opioid-dependent male patients who were admitted to the substance abuse treatment unit at the Institute of Psychiatry, Ain Shams University from June 1, 2006 to May 31, 2008, and who fulfilled the inclusion criteria and agreed to participate in the study. They were assessed 3 weeks after admission and after resolution of most of the withdrawal symptoms using Addiction Severity Index, Beck Depression Inventory, Comprehensive Sleep Disorder Questionnaire, and all-night polysomnography. Ten healthy matched volunteers were taken as controls to be assessed using Sleep Questionnaire and all-night polysomnography. Results Significant differences in sleep complaints included reports of insomnia, hypersomnolence, increased sleep latency, and reduced sleep time in the group of patients. Regarding polysomnography, patients differed significantly from controls, in having prolonged sleep latency, decreased sleep efficiency, increased arousal index, increased stages I and II, and decreased slow wave sleep (SWS). Patients with moderate and severe depressive states had significantly lower SWS than those with mild depressive state. Conclusions Patients with opioid dependence suffer from sleep disturbances that continue for a period of time, even after discontinuation of the abuse drug. The nature of sleep disturbance is related more to NREM sleep, especially SWS and sleep continuity, as well as efficiency parameters. No significant correlation was found between sleep profile and various abuse variables such as duration of abuse and type of opioids.