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Effects of Opiates on Daytime Sleepiness

Alan Tang, MD1, Mark Steven Wallace, MD1, and Sean Drummond, PhD2. (1) Anesthesiology, University of California San Diego, 9500 Gilman Drive, #0924, San Diego, CA 92093, (2) Psychiatry, University of California San Diego, 9500 Gilman Drive, #0924, San Diego, CA 92093

Sleep disturbance and excessive daytime sleepiness is commonly seen in chronic pain patients, especially those consuming chronic opioids. The opioids have been shown to interrupt sleep but very few studies have looked at the effects on daytime sleepiness. This was a pilot study that looked at the differences in daytime sleepiness levels of chronic pain patients who were taking daily opioids as compared to those who were not taking any opioids. Chronic pain patients taking daily opioids and controls were asked to fill out a series of questionnaires that included the following: 1) Patient demographics, 2) Opioid and non-opioid medications, 3) Brief Pain Inventory (BPI), 4) SF-36, 5) Epworth Sleepiness Scale (ESS), 6) Pittsburgh Sleep Quality Index (PSQI). Patients with a sleep disorder or taking medications to treat a psychiatric disorder were excluded. The questionnaire scores were compared using an independent t-test. 103 subjects completed the study with 49 in the control group and 54 in the test group. There were no differences in sex, age, or ethnicity between the groups. Patients on opioids had significantly higher BPI, SF-36, ESS, and PSQI scores than controls suggesting more bodily pain, a worse perception of physical and mental health, more daytime sedation and poorer quality of night time sleep. This study demonstrated negative effects of opioids on sleep and daytime sleepiness. However, the exact mechanism is unknown since the patients on opioids also reported more pain and poorer physical and mental health. A conclusion on the correlation between chronic opioids and sleep cannot be made from this study and further research is needed.