Pain Unit, Health Department of Alicante-General Hospital, Alicante, Spain; Neuropharmacology on Pain (NED), Alicante Institute for Health and Biomedical Research (ISABIAL-FISABIO Foundation), Alicante, Spain.
Neuropharmacology on Pain (NED), Alicante Institute for Health and Biomedical Research (ISABIAL-FISABIO Foundation), Alicante, Spain.
Pain Physician. 2019 Jan;22(1):97-107.
The experience of chronic non-cancer pain (CNCP) is one of the most common reasons individuals seek medical attention. Patients with CNCP frequently experience concomitant sleep-related problems.
The aim was to evaluate sleep problems in opioid naïve CNCP patients, before and after opioid titration, analyzing the influence of OPRM1 gene variants.
A prospective, cohort, observational study.
This study was performed at the Pain Unit of the Alicante University General Hospital.
Pain and Medical Outcomes Study Sleep questionnaire (MOS-Sleep) were assessed at baseline and 3 months after opioid titration in 231 opioid naïve CNCP patients. Sleep data was compared with a matched-control group (n = 64). Morphine equivalent daily doses, adverse events, and drugs prescribed for pain were also registered. OPRM1 polymorphism rs1799971 was analyzed by RT-PCR. Ethics Committee approved the study and results were analyzed by R software.
After 3 months of opioid titration, patients with CNCP (63 ± 14 years, 64% female, VAS 74 ± 17 mm) significantly decreased pain intensity, anxiety and depression, and increased quality of life. Sleep problems were significantly more frequent in females (P = 0.002). Age, quality of life, anxiety, and depression all influenced sleep disturbances and problems indices, which were significantly different from the control group. Furthermore, the OPRM1 118-GG genotype was also associated with significantly lower sleep adequacy, and more sleep problems.
Total number of subjects studied was relatively small and most patients were on other non-opioid centrally-acting medications.
Opioids decreased CNCP severity, improving patients' psychological areas, and quality of life. However, patients with OPRM1 118-GG genotype indicated an increase in sleep problems and worsening sleep pattern while taking opioids.
OPRM1, pharmacogenetics, MOS-Sleep, opioids, chronic noncancer pain, sleep related problems, sleep problem index SLP-6 and SLP-9.
慢性非癌痛（CNCP）的体验是个体寻求医疗关注的最常见原因之一。CNCP 患者常伴有睡眠相关问题。
评估阿片类药物初治 CNCP 患者在阿片类药物滴定前后的睡眠问题，并分析 OPRM1 基因变异的影响。
前瞻性队列观察性研究。
本研究在阿利坎特大学总医院疼痛科进行。
231 例阿片类药物初治 CNCP 患者在阿片类药物滴定前和滴定后 3 个月进行疼痛和医疗结局研究睡眠问卷（MOS-Sleep）评估。将睡眠数据与匹配的对照组（n=64）进行比较。还记录了吗啡等效日剂量、不良反应和用于治疗疼痛的药物。通过 RT-PCR 分析 OPRM1 多态性 rs1799971。伦理委员会批准了该研究，结果由 R 软件进行分析。
阿片类药物滴定 3 个月后，CNCP 患者（63±14 岁，64%女性，VAS 74±17mm）疼痛强度、焦虑和抑郁显著降低，生活质量提高。女性睡眠问题更常见（P=0.002）。年龄、生活质量、焦虑和抑郁均影响睡眠障碍和问题指数，与对照组有显著差异。此外，OPRM1 118-GG 基因型与睡眠充足率显著降低和更多睡眠问题相关。
研究的受试者总数相对较少，大多数患者还在服用其他非阿片类中枢作用药物。
阿片类药物降低了 CNCP 的严重程度，改善了患者的心理状态和生活质量。然而，携带 OPRM1 118-GG 基因型的患者在服用阿片类药物时，睡眠问题增加，睡眠模式恶化。
OPRM1、药物遗传学、MOS-Sleep、阿片类药物、慢性非癌痛、睡眠相关问题、睡眠问题指数 SLP-6 和 SLP-9。
