Correlates of sleep quality and excessive daytime sleepiness in people with opioid use disorder receiving methadone treatment

Baldassarri, Stephen R.; Beitel, Mark; Zinchuk, Andrey; Redeker, Nancy S.; Oberleitner, David E.; Oberleitner, Lindsay; Carrasco, Danilo; Madden, Lynn M.; Lipkind, Nathan; Fiellin, David A.; Bastian, Lori A.; Chen, Kevin; Yaggi, H. Klar; Barry, Declan T.

doi:10.1007/s11325-020-02123-z

Cited by 16 publications

(9 citation statements)

References 33 publications

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“…When acutely administered in healthy adults, opioids have been shown to decrease sleep efficiency and increase awakenings 60 . Long-term opioid consumption is also associated with daytime sleepiness in humans, and we observed a similar effect in our model in the period immediately after fentanyl was removed 61,62 . While we did not differentiate between different stages of sleep in our study, previous work in humans suggests that opioid use may decrease time in periods of deep sleep 23,26,63 .…”

Section: Discussionsupporting

confidence: 79%

Oral Fentanyl Consumption and Withdrawal Impairs Fear Extinction Learning and Enhances Basolateral Amygdala Principal Neuron Excitatory-Inhibitory Balance in Male and Female Mice

Downs,

Kmiec,

McElligott

2023

Preprint

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The number of opioid overdose deaths has increased over the past several years, mainly driven by an increase in the availability of highly potent synthetic opioids, like fentanyl, in the illicit drug supply. While many previous studies on fentanyl and other opioids have focused on intravenous administration, other routes of administration remain relatively understudied. Here, we used a drinking in the dark (DiD) paradigm to model oral fentanyl self-administration using increasing fentanyl concentrations in male and female mice over 5 weeks. Fentanyl consumption peaked in both female and male mice at the 30 µg/mL dose, with female mice consuming significantly more fentanyl than male mice. Mice consumed enough fentanyl to precipitate withdrawal with naloxone, with males having more severe withdrawal symptoms. Fentanyl consumption disrupted normal sleep rhythms in both male and female mice. We also performed behavioral assays to measure approach/avoidance behavior and reward-seeking during fentanyl abstinence. Female mice showed more avoidance behaviors in the open field assay, whereas male mice showed evidence of these behaviors in the light/dark box assay. Female mice also showed increased reward-seeking in the sucrose preference test. Fentanyl-consuming mice of both sexes showed impaired cued fear extinction learning following fear conditioning. Our experiments show that long-term oral fentanyl consumption disrupts sleep rhythms, promotes anxiety-like behavior, increases motivation for reward, and disrupts fear extinction learning. This model could be useful to further study fentanyl withdrawal syndrome and anxiety-like phenotypes associated with protracted fentanyl withdrawal.

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Section: Discussionsupporting

confidence: 79%

Oral Fentanyl Consumption and Withdrawal Impairs Fear Extinction Learning and Enhances Basolateral Amygdala Principal Neuron Excitatory-Inhibitory Balance in Male and Female Mice

Downs,

Kmiec,

McElligott

2023

Preprint

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“…The other parameters, such as psychological distress, emotional recovery, and quality of life, are measured following Meijer, de Vries, and van Bruggen (2011) , Li and Ahlstrom (2016) , and Whoqol (1995) , respectively. Despite there are many scales to measure psychological distress, the study used the scale of Meijer et al (2011) because this measurement scale is widely used in psychology and medical research ( Baldassarri et al, 2020 ; Pachankis et al, 2020 ). Unlike the scales of Calderon et al (2020) and Mewton et al 2016 ), this scale provides robustness and complete cognitive reactions of psychological distress with the inclusion of anxiety, depression, and somatization.…”

Section: Methodsmentioning

confidence: 99%

Quality of life in the COVID-19 outbreak: influence of psychological distress, government strategies, social distancing, and emotional recovery

Khan¹,

Kamruzzaman²,

Rahman³

et al. 2021

Heliyon

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Considering the severity of the effects of COVID-19 on psychological health and quality of life, the present study investigates the direct effects of government strategies and social distancing and the moderating effect of emotional recovery on psychological distress and quality of life using the tenets of the theory of attachment and learned helplessness. The snowball sampling technique was used to recruit respondents from Bangladesh who completed a self-administered questionnaire via Google Forms, which provided cross-sectional data. The results revealed that both social distancing and government strategies have significant negative influences on psychological distress. Besides, government strategies have a significant positive influence on social distancing. Although psychological distress has a significant negative influence on quality of life, emotional recovery shows no moderating effect on the relationship between psychological distress and quality of life during the COVID-19 pandemic. The study provides insights for regulatory bodies and policymakers for developing effective policy interventions to ensure the well-being of people during this pandemic. Finally, the study highlights the implications for both theory and practice and a few notes for further research.

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“…Differences greater than 3 on the PSQI are generally considered clinically meaningful; however, 2 separate systematic reviews have identified differences between 1.54 and 3 as clinically meaningful. 57 , 58 Disrupted sleep can be a major challenge for patients with OUD, 59 , 60 and several trials are focusing on sleep as a therapeutic target for OUD (eg, NCT04287062 ). Sleep itself may have large placebo effects that can be manipulated by conditioning paradigms.…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of Conditioned Open-label Placebo With Methadone in Treatment of Opioid Use Disorder

et al. 2023

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ImportanceMethadone treatment is the most effective evidence-based treatment for opioid use disorder (OUD), but challenges related to dosing and premature treatment dropout argue for adjunct interventions to improve outcomes. One potential behavioral intervention with low risk involves harnessing placebo effects.ObjectiveTo determine the effect of a pharmacologically conditioned open-label placebo (C-OLP) on 90-day methadone dose, retention, drug use, withdrawal, craving, quality of life, and sleep.Design, Setting, and ParticipantsThis 2-arm, open-label, single-blind randomized clinical trial was conducted between December 5, 2017, and August 2, 2019, in an academically affiliated community opioid treatment program. Analyses were conducted between October 1, 2019, and April 30, 2020. A total of 320 newly enrolled adults seeking treatment for moderate to severe OUD were assessed for study eligibility; 131 met eligibility criteria, provided informed consent, and were randomized to either C-OLP or treatment as usual (TAU) in an unequal-block (3:2) manner. Exclusion criteria were pregnancy, hospital/program transfers, and court-ordered treatment.InterventionsParticipants randomized to C-OLP received pharmacologic conditioning and a placebo pill and methadone, and participants randomized to TAU were given methadone only. Participants met with the study team 5 times: at baseline (treatment intake) and 2, 4, 8, and 12 weeks postbaseline. Interactions were balanced between the 2 groups.Main Outcomes and MeasuresOutcomes included 90-day methadone dose (primary) and treatment retention, drug use, withdrawal, craving, quality of life, and sleep quality (secondary). Analyses were conducted as intention-to-treat.ResultsOf the 131 people enrolled in the study, 54 were randomized to TAU and 77 to C-OLP. Mean (SD) age was 45.9 (11.2) years; most of the participants were Black or African American (83 [63.4%]) and male (84 [64.1%]). No significant group differences were observed in the mean (SD) 90-day methadone dose (83.1 [25.1] mg for group TAU, 79.4 [19.6] mg for group C-OLP; t = 0.621991; P = .43), but the groups differed significantly in their retention rates: 33 (61.1%) for TAU and 60 (77.9%) for C-OLP (χ21 = 4.356; P = .04; number needed to treat for the beneficial outcome of 3-month treatment retention, 6; 95% CI, 4-119). C-OLP participants also reported significantly better sleep quality.Conclusions and RelevanceIn this randomized clinical trial, C-OLP had no effect on the primary outcome of 90-day methadone dose. However, C-OLP participants were significantly more likely to remain in treatment. These findings support the use of C-OLP as a methadone treatment adjunct, but larger trials are needed to further examine the use of C-OLP.Trial RegistrationClinicalTrials.gov Identifier: NCT02941809

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Correlates of sleep quality and excessive daytime sleepiness in people with opioid use disorder receiving methadone treatment

Cited by 16 publications

References 33 publications

Oral Fentanyl Consumption and Withdrawal Impairs Fear Extinction Learning and Enhances Basolateral Amygdala Principal Neuron Excitatory-Inhibitory Balance in Male and Female Mice

Oral Fentanyl Consumption and Withdrawal Impairs Fear Extinction Learning and Enhances Basolateral Amygdala Principal Neuron Excitatory-Inhibitory Balance in Male and Female Mice

Quality of life in the COVID-19 outbreak: influence of psychological distress, government strategies, social distancing, and emotional recovery

Effectiveness of Conditioned Open-label Placebo With Methadone in Treatment of Opioid Use Disorder

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