Documented poor sleep among methadone-maintained patients is associated with chronic pain and benzodiazepine abuse, but not with methadone dose

Following the findings of perceived poor sleep and of chronic pain among former heroin addicts, current methadone maintenance treatment (MMT) patients, and its possible relation to methadone dose, we studied these patients' objective sleep parameters. Former heroin addicts maintained on Low (n=19, <80 mg/d) or High (n=25, >150 mg/d) methadone doses, underwent one-night polysomnography (PSG). Patients fitted Pittsburgh Steep Quality Index (PSQI) and chronic pain questionnaires, and current drug abuse was assessed by urine tests. Results: Of the 44 patients, 18 (40.9%) had chronic pain, white 24 (54.5%) abused BDZ. High vs. Low methadone dose groups had more years of opiate abuse and lower % of NREM (non rapid eye movement) deep sleep (stages 3-4) with no other differences between groups. Years of opiate abuse and NREM stages 3-4 inversely correlated (R=-0.34, p=0.03). Chronic vs. non-chronic pain patients had lower steep efficiency and steep time, and higher wake stage. BDZ abusers vs. no-BDZ abusers had shorter % of NREM stages 3-4, shorter REM % and longer % of NREM tight steep (stage 2). Perceived steep (as assessed by the PSQI) was worse among the chronic pain group and among the BDZ abusers. Conclusions: Patients with chronic pain or BDZ abuse presented both perceived and objective poorer steep, regardless of methadone dosage. Steep evaluation and treatment should address these two prevalent conditions in order to improve MMT patients' quality of steep (and of life) and overall treatment outcome. (C) 2009 Elsevier B.V. and ECNR. All rights reserved.