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A prospective, longitudinal study of sleep disturbance and comorbidity in opiate dependence (the ANRS Methaville study)

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Abstract

Rationale/objectives

Sleep disturbance is frequent in opioid-dependent patients. To date, no data are available about the impact of methadone maintenance treatment on sleep disturbance. Using 1-year follow-up data from the Methaville trial, we investigated the impact of methadone initiation and other correlates on sleep disturbance in opioid-dependent patients.

Methods

Sleep disturbance severity was evaluated using two items from different scales (Center for Epidemiological Studies Depression Scale for depression and Opiate Treatment Index). We assessed the effect of methadone and other correlates on sleep disturbance severity during follow-up (months 0, 6, and 12) using a mixed multinomial logistic regression model.

Results

We included 173 patients who had 1-year follow-up data on sleep disturbance, corresponding to 445 visits. At enrolment, 60.5 % reported medium to severe sleep disturbance. This proportion remained stable during methadone treatment: 54.0 % at month 6 and 55.4 % at month 12. The final multivariate model indicated that younger patients (odds ratio (OR) [95 % CI] 0.95 [0.90–1.00]), patients with pain (OR [95 % CI] 2.45 [1.13–5.32]), patients with high or very high nicotine dependence (OR [95 % CI] 5.89 [2.41–14.39]), and patients at suicidal risk (2.50 [1.13–5.52]) had a higher risk of severe sleep disturbance. Because of collinearity between suicidal risk and attention deficit hyperactivity disorder (ADHD) symptoms, ADHD was not associated with sleep disturbance in the final model. Receiving methadone treatment had no significant effect on sleep disturbance.

Conclusions

Sleep disturbance is frequent among opioid-dependent patients. It can be regarded as an important signal of more complex psychiatric comorbidities such as suicidal risk and ADHD. However, sleep disturbance should not be considered an obstacle to methadone maintenance treatment (MMT) initiation or continuation.

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Abbreviations

ANRS:

Agency for Research on Aids and Viral Hepatitis

AUDIT:

Alcohol Use Disorders Identification Test

CATI:

Computer-Assisted Telephone Interview

CES-D:

Center for Epidemiological Studies Depression Scale

DSM-IV:

Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition

IQR:

Interquartile Range

MINI:

Mini-International Neuropsychiatric Interview

MMT:

Methadone Maintenance Treatment

PSQI:

Pittsburgh Sleep Quality Index

OR:

Odds ratio

OTI:

Opiate Treatment Index

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Acknowledgments

This study received external funding from the French National Agency for Research on Aids and Viral Hepatitis (ANRS) and the French Ministry of Health. We thank all members of the ANRS Methaville Study Group. We especially thank all physicians involved in the trial and all patients who took part in this study. Finally, we thank Jude Sweeney for the English revision and editing of our manuscript.

The ANRS Methaville Study Group

Scientific Committee: P.M. Carrieri (principal investigator), A. Morel (principal investigator), L. Michel, M. Mora, P. Roux, JF. Aubertin, S. Robinet, JC. Desenclos, J. Cohen, A. Herszkowicz, C. Paul, I. Porteret, T. Sainte Marie.

Safety committee: J. Bachellier, P. Beauverie, JP Couteron, C. Marty-Double, M. Vray.

International committee of experts: R. Baker, H. Catania, M. Gossop, R. Haemmig, M. Torrens, A. Wodak.

Physicians: Dr. Achard, Dr. Aizpurua, Dr. Aubertin, Dr. Azalbert, Dr. Balteaubijeau, Dr. Bartolo, Dr. Berger, Dr. Bibette, Dr. Biderman, Dr. Blochlaine, Dr. Cadart, Dr. Casenave, Dr. Castera, Dr. Causse, Dr. Corlieu, Dr. Delile, Dr. Demasse, Dr. Depieds, Dr. Dewost, Dr. Drosson, Dr. Duffez, Dr. Faust, Dr. Gassmann, Dr. Guena, Dr. Guillet, Dr. Gutenkust, Dr. Herouin, Dr. Herran, Dr. Heitz, Dr. Kerloc’h, Dr. Khouri, Dr. Lang, Dr. Lasalarie, Dr. Lavignasse, Dr. Magnin, Dr. Maire, Dr. Margelis, Dr. Marre, Dr. Mauraycaplanne, Dr. Michel, Dr. Morel, Dr. Nemayech, Dr. Noss, Dr. Pages, Dr. Paillou, Dr. Partouche, Dr. Petit, Dr. Pouclet, Dr. Raulin, Dr. Regard, Dr. Reiller, Dr. Roch, Dr. Rouille, Dr. Sananes, Dr. Sangare, Dr. Truffy, Dr. Vergez, Dr. Vincent, Dr. Wajsbrot.

Centre of Methodology and Management, INSERM U912

Protocol, guidelines, training: MP. Carrieri, L. Michel, M. Mora, P. Roux.

Phone interviews, training, logistics: G. Maradan, J. Biemar, S. Huguet.

Data collection, management, and statistical analyses: P. Kurkdji, C. Taieb, J. Cohen.

Administration: C. Giovannini, MP. Kissikian.

AIDS agency (ANRS): JC. Desenclos, N. Job-Spira, V. Dore, C. Paul, I. Porteret.

French agency for the safety of health products (AFSSPAS): N. Richard.

French Ministry of Health: A. Herszkowicz, N. Prisse.

ASUD association: F. Olivet; AIDES association

Centre of evaluation and information on drug dependence (CEIP): J. Arditti

Author information

Authors and Affiliations

  1. INSERM U912—ORS PACA, 27 boulevard Jean Moulin, 13005, Marseille, France

    Sandra Nordmann, Caroline Lions, Antoine Vilotitch, Marion Mora, Bruno Spire, Gwenaelle Maradan, Perrine Roux & M. Patrizia Carrieri

  2. Université Aix Marseille, IRD, UMR-S912, Marseille, France

    Sandra Nordmann, Caroline Lions, Antoine Vilotitch, Marion Mora, Bruno Spire, Gwenaelle Maradan, Perrine Roux & M. Patrizia Carrieri

  3. ORS PACA, Observatoire Régional de la Santé Provence Alpes Côte d’Azur, Marseille, France

    Sandra Nordmann, Caroline Lions, Antoine Vilotitch, Marion Mora, Bruno Spire, Gwenaelle Maradan, Perrine Roux & M. Patrizia Carrieri

  4. INSERM, Research Unit 669, Paris, France

    Laurent Michel

  5. Université Paris-Sud and Université Paris Descartes, UMR-S0669, Paris, France

    Laurent Michel

  6. Centre Pierre Nicole, Paris, France

    Laurent Michel

  7. Oppelia, Paris, France

    Alain Morel

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  1. Sandra Nordmann
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  2. Caroline Lions
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  3. Antoine Vilotitch
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  4. Laurent Michel
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  10. M. Patrizia Carrieri
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Correspondence to Sandra Nordmann.

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Nordmann, S., Lions, C., Vilotitch, A. et al. A prospective, longitudinal study of sleep disturbance and comorbidity in opiate dependence (the ANRS Methaville study). Psychopharmacology 233, 1203–1213 (2016). https://doi.org/10.1007/s00213-016-4202-4

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