Acute Intravenous Administration of Morphine Perturbs Sleep Architecture in Healthy Pain-Free Young Adults: a Preliminary Study

Abstract

Similar to earlier findings in animals, nondependent opiate addicts, and postoperative patients, morphine was found to reduce duration of slow-wave sleep. Unlike previous reports, however, its acute administration produced a moderate reduction in rapid eye movement sleep and did not increase correlates of arousal (ie, awakenings, electroencephalogram arousals, wake after sleep onset). Future studies should correlate these findings in patients with pain and evaluate whether optimal pain relief with opioid therapy can improve sleep disturbances in pain patients.

Sleep and GABA levels in the oral part of rat pontine reticular formation are decreased by local and systemic administration of morphine

“…Intravenous delivery of morphine also inhibited NREM sleep and REM sleep. These findings suggest that the pontine reticular formation is one site where morphine may act to cause the sleep disruption known to occur in humans (Shaw et al, 2005).This study also revealed differences in the response to morphine that depended upon route of administration. Intravenous morphine administration eliminated normal wakefulness whereas pontine microinjection of morphine increased normal wakefulness.…”

“…Intravenous delivery of morphine also inhibited NREM sleep and REM sleep. These findings suggest that the pontine reticular formation is one site where morphine may act to cause the sleep disruption known to occur in humans (Shaw et al, 2005).…”

“…Unfortunately, opioids have numerous side effects including sleep disruption (Kay et al, 1969, Kay, 1975. In healthy human volunteers, clinically relevant doses of opioids increase light sleep (stage 2), decrease deep sleep (stage 4), and decrease rapid eye movement (REM) sleep (Walder et al, 2001, Shaw et al, 2005. Negative consequences of disrupted sleep include an enhanced sensitivity to pain (Onen et al, 2001a, Onen et al, 2001b, Kundermann et al, 2004, Roehrs et al, 2006 and deficits in daytime performance leading to an increased risk of accidents (reviewed in Durmer and Dinges, 2005).…”

Rare and Serious Side Effects in Chronic Pain after Opioids

“…However, few experimental studies have come out with contradictory results. Administration of opioids can lead to disturbed sleep pattern in numerous ways such as decrease in total sleep time, disturbed arousal-sleep pattern and imbalance between deep sleep and Rapid Eye Movement (REM) sleep [50][51][52]. However, the most controversial fact in these studies was related to the general condition of the cancer patients as the different stages of oncologic process can interfere with normal sleep pattern.…”

The development of potentially better practices to support the neurodevelopment of infants in the NICU

“…278,279 Morphine may decrease both REM and stage III and IV NREM sleep, while increasing stage II NREM sleep. 280 Phenobarbital was shown in an animal model to decrease total REM sleep. 281 Selective serotonin re-uptake inhibitor medications (desipramine, zimeldine, clomipramine) have been used to achieve an animal model for REM sleep deprivation.…”