No Change of Sleep After 6 and 12 Months of Methadone Maintenance Treatment

Abstract

Objective: 

To determine whether the methadone maintenance treatment (MMT) affects sleep.

Methods: 

We prospectively followed up the sleep pattern of 23 opiate addicts when admitted to MMT and after 6 and 12 months of treatment. Pittsburgh Sleep Quality Index, pain self-report questionnaires, urine for drug abuse, and one-night sleep polysomnography were assessed.

Results: 

The baseline sleep indices (sleep time [5.5 ± 1.1 hours], sleep efficiency [80.6% ± 10.5%], rapid eye movement [REM] stage percent of sleep [14.3% ± 8.4%], percent of non-REM stage 3–4 [6.7% ± 8.6%], and Pittsburgh Sleep Quality Index Scores [11.4 ± 4.8]) did not change at 6 and 12 months. Proportion of patients with absent non-REM stage 3–4 reduced (47.8%, 34.8%, 13%, P = 0.03), and mean REM density increased (P = 0.04). Body mass index increased (24 ± 4.2 kg/m², 25.7 ± 4 kg/m², 27.1 ± 4.8 kg/m², P < 0.0005) with no change in the rate of benzodiazepine abuse or chronic pain. No patient had central sleep apnea. The Respiratory Disturbance Index (apnea or hypopnea numbers/sleep hr) increased among 5 patients who increased ≥25% of their entry weight (3.4 ± 4.1, 11.8 ± 10.1, 29.6 ± 30.4 Respiratory Disturbance Index's) but not with the other 18 (3.9 ± 4.8, 6.2 ± 6.2, 7.8 ± 7.4).

Conclusions: 

We conclude that MMT did not negatively affect the opiate addicts' baseline poor perceived and objective sleep. Only extensive weight gain (evident in a minority of patients) was associated with obstructive sleep apnea.