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

Peles, Einat PhD; Schreiber, Shaul MD; Hamburger, Rachel Bar PhD; Adelson, Miriam MD

Journal of Addiction Medicine: June 2011 - Volume 5 - Issue 2 - p 141-147
doi: 10.1097/ADM.0b013e3181e8b6c4
Original Research

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.

From the Dr. Miriam and Sheldon G. Adelson Clinic for Drug Abuse Treatment and Research (EP, SS, MA), Tel Aviv Sourasky Medical Center, Tel-Aviv; Department of Psychiatry (EP, SS), Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv; and The Israel Anti-Drug Authority (RBH), Jerusalem, Israel.

Received for publication December 20, 2009; accepted May 19, 2010.

Send correspondence and reprint requests to Einat Peles, PhD, Dr. Miriam and Sheldon G. Adelson Clinic for Drug Abuse Treatment and Research, Tel Aviv Sourasky Medical Center, Tel-Aviv, Israel. e-mail:

Supported by grants from the Israeli Anti-Drug Authority and the Adelson Family Foundation.

The first two authors contributed equally to the study and the manuscript preparation.

© 2011 American Society of Addiction Medicine