Sleep Profile in Opioid Dependence: A Polysomnographic Case-Control Study

Purpose: Many opioid receptors are located in the same nuclei that are active in sleep regulation. It has been suggested that opioid peptides are involved in the induction of the sleep state. Prolonged opioid use has been hypothesized to cause disturbed sleep. It also causes excessive daytime sleepiness and fatigue. This study was conducted to compare the polysomnographic sleep profile of patients with opioid dependence with normal matched controls and to see the correlation between various clinical profiles of patients with opioid dependence with their polysomnographic sleep profile. Methods: Fifteen opioid-dependent male patients were selected, and after the detoxification procedure, the patients were assessed using Objective Opioid Withdrawal Scale, Obsessive Compulsive Drug Use Scale, Hamilton Rating Scale for Depression, Hamilton Anxiety Rating Scale, and Global Assessment of Functioning. Fifteen healthy volunteers matched for age, education, and handedness were taken as controls and were assessed using Epworth sleepiness scale and General Health Questionnaire-12. All night polysomnography recording was done on patient and control group, and staging of sleep was done. Results: Patients had significantly decreased total sleep time, sleep efficiency and stage N1 sleep, prolonged sleep latency, and increased limb movement index. No significant correlation was found between sleep profile and various clinical variables. Conclusions: Use of opioids cause sleep disturbance, and these changes occurring in sleep can persist even after substance use has been stopped. Opioids seem to affect non-rapid eye movement stages of sleep.