Chronic Pain and Sleep Quality: Do Opioids Exacerbate Nighttime Disturbance?

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Patients on high-dose opioids have abnormal brain activity
Patients on high-dose opioids have abnormal brain activity

(HealthDay News) — Individuals suffering from chronic pain frequently have nighttime sleep disturbance, and it might be exacerbated by opioid treatment, according to a study published online Aug. 22 in Anaesthesia.

J.A. Robertson, from the University of Oxford in the United Kingdom, and colleagues examined the correlation between chronic pain, opioid analgesia, and sleep quality. Actigraphy, polysomnography, and questionnaires were used to assess 31 participants (10 healthy controls and 21 patients with chronic back pain: six on non-opioid medications and 15 on opioid medications).

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The researchers found that patients with chronic pain reported significant sleep and wake disturbances, as indicated by decreased overall sleep quality, increased insomnia symptoms, and increased fatigue. Patients with chronic pain also spent increased time in bed, took longer to get to sleep, and had high interindividual variability in other measures of activity; no irregular rest-activity pattern was seen overall. Distinctly abnormal brain activity during sleep was seen for patients on high doses of opioids (>100 mg morphine-equivalent/day).

"Nighttime sleep disturbance is common in individuals suffering from chronic pain and may be further exacerbated by opioid treatment," the authors write. "Considerations must be made regarding the appropriate use of combined actigraphy and miniaturized polysomnography for future population-based studies."

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