title: Associations between prescription opioid use and sleep impairment among veterans with chronic pain.
abstract: OBJECTIVE
  Chronic pain is associated with impairments in sleep; however, the relationship between prescription opioid status and sleep is unclear. The primary aim of this study was to examine differences in self-reported sleep quality between groups of patients who varied based on chronic pain and prescription opioid status.
  
  
  METHODS
  This is a cross-sectional study with retrospective review of patient medical records.
  
  
  METHODS
  The study was performed in a single VA medical center located in the Pacific Northwest.
  
  
  METHODS
  Participants with chronic pain and a current prescription for opioid medications (N=72), chronic pain and no opioid prescription (N=104), or who did not report current chronic pain or opioid prescription (N=91) were included.
  
  
  METHODS
  All participants completed self-report questionnaires assessing demographic characteristics, sleep parameters, pain-related variables, and psychiatric symptoms. Data on prescription opioid use were extracted from patients' medical records.
  
  
  RESULTS
  In unadjusted analyses, patients with chronic pain who were prescribed opioids were more likely to have sleep apnea diagnoses in their medical record and reported more impairment on sleep global score and across four sleep parameter subscales (subjective sleep quality, sleep latency, sleep disturbance, and use of sleeping medications). In linear regression analyses controlling for demographic and clinical covariates, prescription opioid status was associated with sleep latency, and opioid dose was significantly associated with sleep latency and sleep global score.
  
  
  CONCLUSIONS
  Prescription opioid status and dose were associated with impairment in self-reported sleep. For patients with chronic pain, consideration should be given to use of nonpharmacological interventions to improve sleep.
authors.affiliation: Mental Health and Clinical Neurosciences Division, Portland VA Medical Center, Portland, Oregon, USA; Center to Improve Veteran Involvement in Care, Portland VA Medical Center, Portland, Oregon, USA; Department of Psychiatry, Oregon Health & Science University, Portland, Oregon, USA.
authors.forename: Benjamin J
authors.initials: BJ
authors.lastname: Morasco
authors.forename: Daniel
authors.initials: D
authors.lastname: O'Hearn
authors.forename: Dennis C
authors.initials: DC
authors.lastname: Turk
authors.forename: Steven K
authors.initials: SK
authors.lastname: Dobscha
mesh_terms: D000701:Analgesics, Opioid / Q000627:therapeutic use*; D059350:Chronic Pain / Q000188:drug therapy*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D055553:Prescription Drugs / Q000627:therapeutic use; D012189:Retrospective Studies; D012893:Sleep Wake Disorders / Q000453:epidemiology*; D011795:Surveys and Questionnaires; D014728:Veterans
chemical_list: D000701:Analgesics, Opioid; D055553:Prescription Drugs
keywords: Chronic Pain; Opioids; Pittsburgh Sleep Quality Index; Sleep