Sleep reductions associated with illicit opioid use and clinic-hour changes during opioid agonist treatment for opioid dependence: Measurement by electronic diary and actigraphy

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Publisher: Elsevier Science Publishers
Document Type: Report
Length: 430 words

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Keywords Actigraphy; Cocaine; Ecological momentary assessment; Opioid use disorder; Sleep Highlights * Healthy sleep is an important aspect of successfully treating opioid use disorders. * We measured sleep in the daily lives of outpatients on opioid agonist therapy. * Participants' sleep duration and timing changed with our clinic's operating hours. * Participants slept less when using opioids and/or both opioids and cocaine. * These results provide an ecologically valid extension of inpatient studies. Abstract Sleep problems are commonly reported during opioid agonist treatment (OAT) for opioid use disorders. Inpatient studies have found both sleep disturbances and improved sleep during OAT. Illicit opioids can also disrupt sleep, but it is unclear how they affect sleep in outpatients receiving OAT. Therefore, we used electronic diary entries and actigraphy to measure sleep duration and timing in opioid-dependent participants (n = 37) treated with methadone (n = 15) or buprenorphine (n = 22). For 16 weeks, participants were assigned to attend our clinic under different operating hours in a crossover design: Early hours (07:00--09:00) vs. Late hours (12:00--13:00) for 4 weeks each in randomized order, followed for all participants by our Standard clinic hours (07:00--11:30) for 8 weeks. Throughout, participants made daily electronic diary self-reports of their sleep upon waking; they also wore a wrist actigraph for 6 nights in each of the three clinic-hour conditions. Drug use was assessed by thrice-weekly urinalysis. In linear mixed models controlling for other sleep-relevant factors, sleep duration and timing differed by drug use and by clinic hours. Compared to when non-using, participants slept less, went to bed later, and woke later when using illicit opioids and/or both illicit opioids and cocaine. Participants slept less and woke earlier when assigned to the Early hours. These findings highlight the role OAT clinic schedules can play in structuring the sleep/wake cycles of OAT patients and clarify some of the circumstances under which OAT patients experience sleep disruption in daily life. Author Affiliation: (a) National Institute on Drug Abuse, Intramural Research Program, Baltimore, MD, USA (b) Rensselaer Polytechnic Institute, Lighting Research Center, Troy, NY, USA * Corresponding author at: 251 Bayview Blvd., Suite 200, Baltimore, MD 21224, USA. Article History: Received 13 June 2019; Revised 13 August 2019; Accepted 13 August 2019 (footnote)1 Present address: Hartwick College, Department of Psychology, Oneonta, NY USA. Byline: Jeremiah W. Bertz [jeremiah.bertz@nih.gov] (a,*), David H. Epstein (a), David Reamer (a), William J. Kowalczyk (a,1), Karran A. Phillips (a), Ashley P. Kennedy (a), Michelle L. Jobes (a), Greg Ward (b), Barbara A. Plitnick (b), Mariana G. Figueiro (b), Mark S. Rea (b), Kenzie L. Preston (a)

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Gale Document Number: GALE|A599772474