Department of Medicine, Alpert Medical School of Brown University, Providence, RI 02906, USA.
Drug Alcohol Depend. 2010 Apr 1;108(1-2):77-83. doi: 10.1016/j.drugalcdep.2009.11.019. Epub 2010 Jan 15.
Opioid-dependent patients treated with methadone have subjective sleep complaints and disrupted sleep on polysomnography (PSG). Previous studies of sleep-disordered breathing (SDB) in this population have focused on central sleep apnea (CSA). Our objectives were to: (1) characterize obstructive sleep apnea (OSA) and CSA in patients in methadone maintenance treatment (MMT) for opioid dependence; (2) examine factors associated with SDB in this population; and (3) investigate whether SDB was related to severity of subjective sleep complaints in MMT patients with subjective sleep disturbances.
We analyzed OSA and CSA from one night of home PSG in 71 patients who were in MMT for at least 3 months and had a Pittsburgh Sleep Quality Inventory (PSQI) score >5.
OSA (defined as obstructive apnea-hypopnea index (OAHI) > or = 5) was observed in 35.2% of our sample. OSA was associated with higher body mass index, longer duration in MMT, and non-Caucasian race. CSA (defined as central apnea index (CAI) > or = 5) was observed in 14.1% of the sample. CSA was not associated with methadone dose or concomitant drug use. Subjective sleep disturbance measured with the PSQI was not related to OSA or CSA.
SDB was common in this sample of MMT patients and OSA was more common than CSA. Given the lack of association between presence of SDB and severity of subjective sleep difficulties, factors other than sleep apnea must account for complaints of disturbed sleep in this population.
接受美沙酮治疗的阿片类药物依赖患者存在主观睡眠抱怨和多导睡眠图（PSG）睡眠中断。以前对该人群睡眠呼吸障碍（SDB）的研究集中在中枢性睡眠呼吸暂停（CSA）上。我们的目的是：（1）描述美沙酮维持治疗（MMT）的阿片类药物依赖患者中阻塞性睡眠呼吸暂停（OSA）和 CSA；（2）研究该人群中与 SDB 相关的因素；（3）研究 SDB 是否与 MMT 患者的主观睡眠障碍和主观睡眠抱怨的严重程度相关。
我们分析了 71 名接受 MMT 治疗至少 3 个月且匹兹堡睡眠质量指数（PSQI）评分>5 的患者在家进行的一晚 PSG 的 OSA 和 CSA。
我们的样本中有 35.2%存在 OSA（定义为阻塞性呼吸暂停低通气指数（OAHI）≥5）。OSA 与较高的体重指数、在 MMT 中的持续时间较长以及非白种人种族有关。CSA（定义为中心性呼吸暂停指数（CAI）≥5）在样本中占 14.1%。CSA 与美沙酮剂量或同时使用药物无关。使用 PSQI 测量的主观睡眠障碍与 OSA 或 CSA 无关。
在该 MMT 患者样本中，SDB 很常见，且 OSA 比 CSA 更常见。鉴于 SDB 的存在与主观睡眠困难的严重程度之间没有关联，除了睡眠呼吸暂停外，其他因素必须解释该人群的睡眠障碍抱怨。
