head JofIMAB
Journal of IMAB - Annual Proceeding (Scientific Papers)
Publisher: Peytchinski Publishing Ltd.
ISSN: 1312-773X (Online)
Issue: 2021, vol. 27, issue2
Subject Area: Dental Medicine
DOI: 10.5272/jimab.2021272.3817
Published online: 28 June 2021

Original article

J of IMAB. 2021 Apr-Jun;27(2):3817-3822
Christiana Madjova1ORCID logo Corresponding Autoremail, Simeon Chokanov1ORCID logo, Mario Milkov2ORCID logo,
1) Department of Conservative Dentistry and Oral Pathology, Faculty of Dental Medicine, Medical University – Varna
2) Department of Dental Materials Science, and Propaedeutics of Prosthetic Dental Medicine, Faculty of Dental Medicine, Medical University – Varna, Bulgaria.

Introduction: Methadone therapy is the mainstay of treatment of addict patients. The most common side effects are: dizziness, drowsiness, vomiting, sweating, dry mouth and constipation. The more serious complications that can be observed are: sleep apnea, аbnormal heart rhythms, respiratory problems, euphoria, disorientation, anxiety, seizures and more.
Purpose: The purpose of this study is to determine the correlation between methadone maintenance treatment and sleep apnea in addict patients.
Materials and methods: The subject of the study are 81 methadone-treated drug-dependent patients, mean age 39 ± 9,07 years.
Results: The answers we received: 79% (64) of drug addicts have problems with sleep; 30.9% of them (25) reported having insomnia; 44.4% (36) experience morning fatigue; 56.8% (46) of the respondents said they were drowsy during the day and 63% of the respondents reported a change in mood; 21% (17) had a short sleep, and 26% (21)reported snoring and 18 of them have loud bothering snoring; 68% answered that they don't have problems with falling asleep and only 21% don’t wake up frequently in the evening. In 83.9% nobody noticed cessation of breathing during sleep. 73.8% never nodded off or fallen asleep while driving a vehicle. 16.1% have been treated for high blood preasure, and only 2.5% have obesity.
Conclusions: Our survey found that there is a correlation between methadone therapy and sleep of patients. The key to improving the condition and reducing the risk of central sleep apnea is the monitoring of patients, as well as a combination of different types of treatment.

Keywords: Methadone, Opiate dependence, Drug addicts, Sleep apnea, Central sleep apnea, Sleep disorders,

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Please cite this article as: Madjova C, Chokanov S, Milkov M. Correlation between sleep apnea and methadone therapy. J of IMAB. 2021 Apr-Jun;27(2):3817-3822. DOI: 10.5272/jimab.2021272.3817

Corresponding AutorCorrespondence to: Christiana Madjova, Department of Conservative Dentistry and oral pathology, Faculty of Dental Medicine, Medical University – Varna; 84, TzarOsvoboditel Blvd., 9000 Varna, Bulgaria; E-mail: christiana.madjova@gmail.com

1. Martin WR, Jasinski DR, Haertzen CA, Kay DC, Jones BE, Mansky PA, et al. Methadone--a reevaluation. Arch Gen Psychiatry. 1973 Feb;28(2):286-95. [PubMed]
2. Nicholson  AB, Watson  GR, Derry  S, Wiffen  PJ. Methadone for cancer pain. Cochrane Database Syst Rev. 2017 Feb 8;2(2):CD003971. [PubMed]
3. John J, Amley X, Bombino G, Gitelis C, Topi B, Hollander G, et al. Torsade de Pointes due to Methadone Use in a Patient with HIV and Hepatitis C Coinfection. Cardiol Res Pract. 2010 Dec 30;2010:524764. [PubMed]
4. Sinha S. Methadone. Drugs.com. Nov. 2019 [Internet]
5. Koob G, Arends M, Le Moal M. Drugs, Addiction, and the Brain. 1st Edition. Academic Press, Elsevier. 2014. Chapter 1: vii. [Internet]
6. Fudin HR, Babin JL, Hong JT, Ku J, May AL, Wisner A, et al. Drugs of Abuse. Side Effects of Drugs Annual. Volume 40, 2018. Chapter 4. pp.29-89 [Crossref]
7. Khazaie H, Najafi F, Ghadami MR, AzamiA, Nasouri M, Tahmasian M, et al. Sleep Disorders in Methadone Maintenance Treatment Volunteers and Opium-dependent Patients. Addict Health. 2016 Apr;8(2):84-89. [PubMed]
8. Correa D, Farney RJ, Chung F, Prasad A, Lam D, Wong J. Chronic opioid use and central sleep apnea: a review of the prevalence, mechanisms, and perioperative considerations. Anesth Analg. 2015 Jun;120(6):1273-85. [PubMed]
9. Chung F, Yegneswaran B, Liao P, Chung SA, Vairavanathan S, Islam S, Khajehdehi A, Shapiro CM. STOP questionnaire: a tool to screen patients for obstructive sleep apnea. Anesthesiology. 2008 May;108(5):812-21
10. Abrishami A, Khajehdehi A, Chung F. A systematic review of screening questionnaires for obstructive sleep apnea. Can J Anesth/J Can Anesth (2010) 57:423–438
11. Randerath WJ, George S. Opioid-induced sleep apnea: is it a real problem? J Clin Sleep Med. 2012 Oct 15;8(5):577-8. [PubMed]
12. Webster LR. Methadone Side Effects: Constipation, Respiratory Depression, Sedation, Sleep-Disordered Breathing, and the Endocrine System. In: Handbook of Methadone Prescribing and Buprenorphine Therapy. Editors Cruciani R, Knotkova H. Springer, New York, NY. 2013. pp.39-49. [Crossref]
13. Charpentier A, Bisac S, Poirot I, Vignau J, Cottencin O. Sleep quality and apnea in stable methadone maintenance treatment. Subst Use Misuse. 2010 Jul;45(9):1431-4. [PubMed]
14. Guilleminault C, Cao M, Yue HJ, Chawla P. Obstructive sleep apnea and chronic opioid use. Lung. 2010 Dec;188(6):459-68. [PubMed]
15. Sharkey KM, Kurth ME, Anderson BJ, Corso RP, Millman RP, Stein MD.  Obstructive sleep apnea is more common than central sleep apnea in methadone maintenance patients with subjective sleep complaints. Drug and Alcohol Dependence, 2010; 108(1-2), 77–83
16. Troitino A, Labedi N, Kufel T, El-Solh AA. Positive airway pressure therapy in patients with opioid-related central sleep apnea. Sleep Breath. 2014 May;18(2):367-73. [PubMed]

Received: 24 June 2020
Published online: 28 June 2021

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