Home Polysomnography in Methadone Maintenance Patients with Subjective Sleep Complaints

Abstract

Objective: Most patients in methadone maintenance treatment (MMT) complain of poor sleep. Few studies have examined MMT patients' sleep using polysomnography (PSG), and none to our knowledge have employed home PSG. Standard sleep laboratory research protocols often require two consecutive PSG nights because of inter-night variability in sleep attributed to first-night adaptation to a novel sleep environment and recording procedures. The purpose of this study was to assess the stability of sleep measures across two consecutive nights of home PSG in opioid-dependent MMT patients. Methods: Home PSG was performed in 50 MMT patients with subjective sleep complaints. Participants were 54% female and 82% white with mean age = 36.8 years, median methadone dose = 100 mg/day, and median MMT duration = 286 days. Results: Thirty-six participants completed two consecutive nights of at-home PSG and 14 completed one. For the former group, no differences in sleep measures were found across recordings. The one-night group had significantly less total sleep time, Stage 2 sleep, REM sleep, and shorter REM latency than the two-night group. Conclusions: Home PSG is a viable method for recording sleep in opioid-dependent MMT patients, and was stable across consecutive nights of study. Two nights of home PSG for MMT patients, therefore, are not necessarily required and confidence in the reliability of data from one night of recording can be assumed. Excluding MMT research participants with one PSG may exclude patients with the worst sleep—precisely the group that most warrants investigation.

Keywords:

• Home monitoring
• methadone
• opioid dependence
• polysomnography
• sleep