A new study examined if using opioids can help pain patients get a better night's sleep.
People with chronic pain often rely on opioids to manage their discomfort through the night and get a better night’s sleep, but a new scientific review indicates that opioids don’t usually improve the quality of sleep, and may actually make sleep worse.
Authors of the review, published in the journalSleep Study Reviews, found that although people often self-reported that they got better sleep while on opioids, “the effect is inconsistent, small, and may be accompanied by excessive daytime sleepiness.”
Lead study author Dr. Nicole Tang told Science Dailythat studies need to use objective measurements of sleep quality, since self-reporting by patients can often be unreliable.
"The way people experience sleep could be quite different from what you get from physiological measurements. It is not uncommon for patients to report an improvement in their sleep quality when the severity of sleep disordered breathing has increased and without significant changes in important parameters reflecting deeper and more restorative sleep,” she said. “This phenomenon is perplexing, and may reflect the inherent challenge in reconciling a wide range of ambiguous bodily information to make a categorical judgement whether sleep has improved or not after opioid therapy."
One of the reasons that opioids may not improve sleep is because opioids affect the breathing system. This can make people more likely to deal with sleep apnea events, which affect the quality of sleep.
According to Science Daily, insomnia is 42% more common among pain patients taking opioids than it is among pain patients who are not on opioids.
Tang said that there needs to be more studies on the use of opioids to assist with sleep. Future studies should include examinations of how different opioid doses affect sleep differently, she said. Study co-author Dr. Harbinder Sandhu is currently doing more research into opioids and sleep.
"The benefits of opioids on managing chronic pain in the short term is well-evidenced,” she said. “But we have not seen long-term benefits in managing pain and the effect on sleep is unknown. Results of the study will help to inform future interventions in opioid pain management.”
Dr. Chantal Berna, another study co-author, said that people need to talk with their doctors about the benefits and drawbacks of using opioids to enhance sleep.
"Decisions regarding introducing or maintain[ing] long term opioid therapy are based on balancing risks and benefits with the patient suffering from chronic pain,” Berna said. “Given that side effects and risks are sometimes not clear to patients, assessing vigilance as well as sleep both subjectively and with overnight objective measures before and after introducing opioids can be useful."