title: Long-term quality of sleep after remifentanil-based anaesthesia: a randomized controlled trial.
abstract: BACKGROUND
  Clinical and pre-clinical data agree that opioids disrupt sleep architecture. Recently, remifentanil has been suggested to cause possible long-term disturbances of sleep quality. This randomized controlled clinical trial was designed to substantiate or refute a possible long-term effect of remifentanil on the quality of sleep.
  
  
  METHODS
  One hundred patients undergoing elective surgery were randomized to receive either fentanyl or remifentanil-based anaesthesia. Before operation (T0) and 3 (T3) and 6 (T6) months after operation, the quality of sleep was assessed by the Pittsburgh Sleep Quality Index (PSQI).
  
  
  RESULTS
  Overall, the quality of sleep for patients in the remifentanil or fentanyl group was not significantly different at any time point. Patients in the fentanyl group screened as good sleepers before operation showed no differences across time course of the study in PSQI scores. In contrast, good sleepers in the remifentanil group had significantly impaired sleep quality for at least 3 months after operation. Patients who were before operation screened as poor sleepers showed no significant changes in PSQI scores at T3 and T6 in both groups.
  
  
  CONCLUSIONS
  The intraoperative use of remifentanil in a general patient population does not significantly alter the quality of sleep in the postoperative period. However, it may result in a significant reduction in the quality of sleep in patients before operation considered good sleepers. These changes were not observed in the group of patients receiving fentanyl. The relevance of these findings in terms of patient recovery and quality-of-life warrants further investigation. Trial Registration. ACTRN12610000362099.
authors.affiliation: Department of Anaesthesiology, Intensive Care and Pain Medicine, University Hospital Muenster, Albert-Schweitzer-Campus 1, A1, 48149 Muenster, Germany. manuelwenk@uni-muenster.de
authors.forename: M
authors.initials: M
authors.lastname: Wenk
authors.forename: D M
authors.initials: DM
authors.lastname: Pöpping
authors.forename: G
authors.initials: G
authors.lastname: Chapman
authors.forename: H
authors.initials: H
authors.lastname: Grenda
authors.forename: T
authors.initials: T
authors.lastname: Ledowski
mesh_terms: D000082:Acetaminophen / Q000008:administration & dosage / Q000627:therapeutic use; D000293:Adolescent; D000328:Adult; D018712:Analgesics, Non-Narcotic / Q000008:administration & dosage / Q000627:therapeutic use; D000771:Anesthesia, Intravenous / Q000009:adverse effects; D018686:Anesthetics, Intravenous / Q000009:adverse effects; D004311:Double-Blind Method; D019277:Entropy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures; D010149:Postoperative Pain / Q000188:drug therapy; D010880:Piperidines / Q000009:adverse effects; D020250:Postoperative Nausea and Vomiting / Q000517:prevention & control; D000077208:Remifentanil; D018401:Sample Size; D058831:Serotonin 5-HT3 Receptor Antagonists / Q000627:therapeutic use; D012890:Sleep / Q000187:drug effects*; D055815:Young Adult
chemical_list: D018712:Analgesics, Non-Narcotic; D018686:Anesthetics, Intravenous; D010880:Piperidines; D058831:Serotonin 5-HT3 Receptor Antagonists; D000082:Acetaminophen; D000077208:Remifentanil