The Library
The effect of opioid therapy on sleep quality in patients with chronic non-malignant pain : a systematic review and exploratory meta-analysis
Tools
Tang, Nicole K. Y., Stella, Maria Teresa, Banks, Ptolemy D. W., Sandhu, Harbinder and Berna, Chantal (2019) The effect of opioid therapy on sleep quality in patients with chronic non-malignant pain : a systematic review and exploratory meta-analysis. Sleep Medicine Reviews, 45 . pp. 105-126. doi:10.1016/j.smrv.2019.03.005 ISSN 1087-0792.
|
PDF
WRAP-effect-opioid-therapy-sleep-quality-patients-pain-review-Sandhu-2019.pdf - Accepted Version - Requires a PDF viewer. Available under License Creative Commons Attribution Non-commercial No Derivatives 4.0. Download (1384Kb) | Preview |
Official URL: https://doi.org/10.1016/j.smrv.2019.03.005
Abstract
Current guidelines recommend opioid therapy to chronic non-malignant pain (CNP) patients when the benefits for pain and function outweigh risks. This systematic review examined the effects of opioid therapy on sleep – a valued functional outcome– in CNP. Electronic and hand searches of relevant studies up through July 2017 identified 18 eligible studies providing data from 3,746 CNP patients for analysis. Twelve of these studies were randomised controlled trials (RCTs) of up to 12-month in duration. Low-medium dosed oxycodone and transdermal fentanyl were the most tested therapies (n=4 each). Only two studies used objective sleep measure in addition to self-report ratings, questionnaires or sleep diary. Whilst calmer sleep with less body/leg movements and fewer awakenings could be achieved following opioid therapy, these might occur with increased sleep-disordered breathing and a much-shortened rapid eye movement (REM) sleep latency. Both the narrative synthesis and exploratory meta-analysis suggest that opioid therapy in CNP is associated with improved self-reported sleep quality. However, the effect is inconsistent, small (Standardised Mean Difference = 0.36), and may be accompanied by excessive daytime sleepiness. As a Cochrane-recommended assessment revealed “unclear” or “high” overall risk of bias for all studies, future opioid trials of stronger methodology and better reporting are needed to confirm and elucidate the effect.
Item Type: | Journal Article | ||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Subjects: | R Medicine > RB Pathology | ||||||||||||
Divisions: | Faculty of Science, Engineering and Medicine > Science > Psychology Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
||||||||||||
Library of Congress Subject Headings (LCSH): | Pain medicine, Opioids | ||||||||||||
Journal or Publication Title: | Sleep Medicine Reviews | ||||||||||||
Publisher: | Elsevier Masson | ||||||||||||
ISSN: | 1087-0792 | ||||||||||||
Official Date: | June 2019 | ||||||||||||
Dates: |
|
||||||||||||
Volume: | 45 | ||||||||||||
Page Range: | pp. 105-126 | ||||||||||||
DOI: | 10.1016/j.smrv.2019.03.005 | ||||||||||||
Status: | Peer Reviewed | ||||||||||||
Publication Status: | Published | ||||||||||||
Access rights to Published version: | Restricted or Subscription Access | ||||||||||||
Date of first compliant deposit: | 18 March 2019 | ||||||||||||
Date of first compliant Open Access: | 13 April 2020 | ||||||||||||
RIOXX Funder/Project Grant: |
|
Request changes or add full text files to a record
Repository staff actions (login required)
View Item |
Downloads
Downloads per month over past year