0909 Opioid Use and Sleep among Adults with Chronic Pain: A Daily Process Model. (27th April 2018) - Miller, M B
Abstract: Introduction: Disturbed sleep and use of opioid pain medication are common among individuals with chronic pain; yet few studies have examined opioid impact on sleep at the daily level. This study aimed to determine the extent to which evening use of opioids impacts same-night sleep parameters. Methods: Participants were 208 adults (94% women; 79% White; mean age=51.5, SD =11.7) reporting symptoms of insomnia and chronic pain. They completed daily diaries assessing nighttime pain severity and use of medication for 14 days. Sleep parameters (sleep onset latency, wake after sleep onset, total sleep time, and time in bed) were assessed using actigraphy. Daily associations between use of opioid pain medication (yes/no) and sleep parameters were assessed using multilevel modeling. To determine the extent to which use of opioids impacted sleep above and beyond pain itself, models controlled for self-reported nighttime pain. Models also controlled for gender and use of sleep medication. Results: Use of opioid pain medication was associated with longer sleep onset (γ=12.07, SE =4.47, p =.01), wake after sleep onset ( γ =6.02, SE =2.75, p =.03), and time in bed ( γ =20.03, SE =8.74, p =.02). Specifically, on the days participants reported using opioids, there was a delay in sleep onset by about 12 minutes, an increase in wake after sleep onset by about 6 minutes, and an increase in time in bed by about 20 minutes. There was no association between opioid use and total sleep time ( γ =0.84, SE =7.89, p =.92). Conclusion: Adults with comorbid symptoms of insomnia and chronic pain spent more time awake in bed on nights they reported using opioid pain medication. This effect cannot be attributed to changes in pain, use of sleep medication, or total sleep time. Future research is needed to determine the mechanism by which opioids influence sleep within this population (e.g., change in daytime behaviors, such as napping or resting). Support (If Any): This research was supported by the NIAMS (R01AR055160 and R01AR005160-S1; McCrae, PI). Data were collected as part of clinical trial NCT02001077 Sleep and Pain Interventions (SPIN) at the University of Florida (McCrae, PI).