Comparison of Sleep Problems in Opioid-Dependent Patients under Methadone and Buprenorphine Treatment

  • Mehdi Madanifard Department of Psychology, School of Psychology, Ferdowsi University of Mashhad, Mashhad, Iran
  • Mehrdad Mazaheri Department of Psychology, School of Psychology, University of Sistan and Baluchestan, Sistan and Baluchestan, Iran
  • Imanolah Bigdeli Department of Psychology, School of Psychology, Ferdowsi University of Mashhad, Mashhad, Iran
Keywords: Addiction, Methadone, Buprenorphine, Sleep


Background and Objective: The main aim of the current research was to compare sleep problems in two groups of patients with addiction treated with preservatives substances (i.e., methadone and buprenorphine).Materials and Methods: Two groups of addicts (30 patients treated with methadone and 30 patients treated with buprenorphine) were voluntarily selected using an available sampling method and were asked to complete Pittsburgh sleep quality index (PSQI), Epworth sleepiness scale (ESS), Insomnia Severity Index (ISI), and STOP-BANG question-naires. Data analysis was performed using independent t-test and descriptive indicators at the significant level of 5%.Results:The average age was 39.16 ± 5.07 in the methadone group and 40.30 ± 6.17 years in the buprenorphine group (P < 0.050). All participants were male. Current findings indicated that significant difference existed between the two studied groups in the PSQI (P < 0.001) and ESS (P < 0.010) with the higher mean score for the methadone group. However, buprenorphine group showed higher mean score than methadone group on the ISI and STOP-BANG and the-se differences were found statistically significant (P < 0.010).Conclusion: Sleep problems may be one of the reasons for the failure in the treatment of addiction among patients with addiction.


Connock M, Juarez-Garcia A, Jowett S, et al. Methadone and buprenorphine for the management of opioid dependence: A systematic review and economic evaluation. Health Technol Assess 2007; 11: 1-iv.

Wittchen HU, Apelt SM, Buhringer G, et al. Buprenorphine and methadone in the treatment of opi-oid dependence: methods and design of the COBRA study. Int J Methods Psychiatr Res 2005; 14: 14-28.

Comer SD, Walker EA, Collins ED. Buprenor-phine/naloxone reduces the reinforcing and subjective effects of heroin in heroin-dependent volunteers. Psy-chopharmacology (Berl) 2005; 181: 664-75.

Nalaskowska M, Cierpialkowska L. Social and psychological functioning of opiate dependent patients in methadone maintenance treatment report. Alcohol-ism and Drug Addiction 2014; 27: 237-54.

Barnett PG, Rodgers JH, Bloch DA. A meta-analysis comparing buprenorphine to methadone for treatment of opiate dependence. Addiction 2001; 96: 683-90.

Kundermann B, Krieg JC, Schreiber W, et al. The effect of sleep deprivation on pain. Pain Res Manag 2004; 9: 25-32.

Dimsdale JE, Norman D, DeJardin D, et al. The effect of opioids on sleep architecture. J Clin Sleep Med 2007; 3: 33-6.

Speed TJ, Finan PH, Kowalczyk WJ. Character-ization of objective and subjective sleep in patients receiving buprenorphine maintenance therapy for opi-oid use disorder. Proceedings of the SLEEP 2017: 31st Annual Meeting of the Associated Professional Sleep Societies; 2017 June 3-7; Boston, MA.

Lukas SE, Dorsey CM, Mello NK, et al. Rever-sal of sleep disturbances in cocaine- and heroin-dependent men during chronic buprenorphine treat-ment. Exp Clin Psychopharmacol 1996; 4: 413-20.

Gauthier EA, Guzick SE, Brummett CM, et al. Buprenorphine disrupts sleep and decreases adenosine concentrations in sleep-regulating brain regions of Spra-gue Dawley rat. Anesthesiology 2011; 115: 743-53.

Fischer G, Ortner R, Rohrmeister K, et al. Methadone versus buprenorphine in pregnant addicts: A double-blind, double-dummy comparison study. Addiction 2006; 101: 275-81.

Sharkey KM, Kurth ME, Anderson BJ, et al. Assessing sleep in opioid dependence: A comparison of subjective ratings, sleep diaries, and home poly-somnography in methadone maintenance patients. Drug Alcohol Depend 2011; 113: 245-8.

Buysse DJ, Reynolds CF 3rd, Monk TH, et al. The Pittsburgh Sleep Quality Index: A new instrument for psychiatric practice and research. Psychiatry Res 1989; 28: 193-213.

Gaffari F, Zeighami Mohammadi S. Frequency of daytime sleepiness in hypertensive women. Sci J Hamadan Nurs Midwifery Fac 2011; 19: 5-15.

Masoodzade A, Zangane A, Shahbaznezhad L. Daytime sleepiness in medical students at Mazandaran university of medical sciences, 2003. J Mazandaran Univ Med Sci 2006; 16: 75-80. [In Persian].

Bastien CH, Vallieres A, Morin CM. Validation of the insomnia severity index as an outcome measure for insomnia research. Sleep Med 2001; 2: 297-307.

Morin CM, Belleville G, Belanger L, et al. The Insomnia Severity Index: Psychometric indicators to detect insomnia cases and evaluate treatment response. Sleep 2011; 34: 601-8.

Nagappa M, Liao P, Wong J, et al. Validation of the STOP-bang questionnaire as a screening tool for obstructive sleep apnea among different populations: A systematic review and meta-analysis. PLoS One 2015; 10: e0143697.

Chung F, Yegneswaran B, Liao P, et al. STOP questionnaire: A tool to screen patients for obstructive sleep apnea. Anesthesiology 2008; 108: 812-21.

Peles E, Schreiber S, Adelson M. Variables as-sociated with perceived sleep disorders in methadone maintenance treatment (MMT) patients. Drug Alcohol Depend 2006; 82: 103-10.

Buysse DJ, Reynolds CF 3rd, Kupfer DJ, et al. Clinical diagnoses in 216 insomnia patients using the In-ternational Classification of Sleep Disorders (ICSD), DSM-IV and ICD-10 categories: A report from the APA/NIMH DSM-IV Field Trial. Sleep 1994; 17: 630-7.

Farney RJ, McDonald AM, Boyle KM, et al. Sleep disordered breathing in patients receiving thera-py with buprenorphine/naloxone. Eur Respir J 2013; 42: 394-403.

M. Madanifard, et al.

Pjrek E, Frey R, Naderi-Heiden A, et al. Acti-graphic measurements in opioid detoxification with methadone or buprenorphine. J Clin Psychopharmacol 2012; 32: 75-82.

Ponizovsky AM, Margolis A, Heled L, et al. Improved quality of life, clinical, and psychosocial outcomes among heroin-dependent patients on ambula-tory buprenorphine maintenance. Subst Use Misuse 2010; 45: 288-313.

Angarita GA, Emadi N, Hodges S, et al. Sleep abnormalities associated with alcohol, cannabis, co-caine, and opiate use: A comprehensive review. Addict Sci Clin Pract 2016;11:9.

How to Cite
Madanifard M, Mazaheri M, Bigdeli I. Comparison of Sleep Problems in Opioid-Dependent Patients under Methadone and Buprenorphine Treatment. JSS. 2(1-2):34-9.
Original Article(s)