Opioids, Pain, and Sleep: How Do They Interact With Each Other?

RESULTS:

• Sleep disturbance was correlated with worse pain severity, impaired physical functioning, and greater pain interference in daily activities.¹
• Opioid use was associated with worse pain severity, greater sleep disturbance, and greater pain interference with daily activities but not impaired physical functioning.¹

RESULTS:

• Additional analysis determined that opioids significantly moderated the association of sleep disturbance with physical functioning and pain interference in daily activities.¹
• In the patients who took opioids, greater sleep disturbance was associated with worse physical functioning and greater pain interference.¹
• Opioid use did not appear to be a factor in the association between sleep disturbance and pain severity.¹

CONCLUSIONS:

• The results indicate that the use of opioids among those with chronic low back pain can significantly worsen sleep disturbance, physical functioning, and pain interference.¹
• These findings fit with those of previous studies that have found that opioids, rather than being beneficial for sleep appear to be detrimental and also to add to the impact of pain on the patient’s life.¹

CONCLUSIONS:

• Studies have shown that opioids can interfere with sleep architecture especially slow wave and REM sleep which means although their sedating effects can help people to fall asleep they also interfere with normal sleep cycles.²
• It should be noted that for the same reason alcohol and benzodiazepines, both of which are also sedating, are poor choices for the management of sleep problems.²

CONCLUSIONS:

• Because they are respiratory depressants, opioids can contribute to sleep disordered breathing and exacerbate underlying conditions such as obstructive and central sleep apnea.¹
• Although the current study only included patients without previously identified physical and mental disorders, it is possible that some of the participants may have had undiagnosed breathing disorders that might have been exacerbated by opioids; sleep apnea often is undiagnosed.¹

CONCLUSIONS:

• Both disruption of sleep architecture and sleep apnea with subsequent nonrestive sleep can result in excessive daytime sleepiness and fatigue which would explain this study’s findings of impaired functioning and interference in activities.²
• The extent to which poor sleep can affect pain has been demonstrated by other studies that have shown that disrupting normal sleep in healthy subjects without pain can result in widespread pain similar to the symptoms of fibromyalgia.¹