The impact of opioid medications on sleep architecture and nocturnal respiration during acute recovery from moderate to severe traumatic brain injury: A TBI model systems study

Model System:

TBI

Reference Type:

Journal article

Accession No.:

J87448

Journal:

Journal of Head Trauma Rehabilitation

Year, Volume, Issue, Page(s):

2021 , 36, 5, 374-387

Publication Website:

Abstract:

Study identified patient and clinical characteristics associated with receipt of opioid medications and examined differences in sleep quality, architecture, and sleep-related respiration between those receiving and not receiving opioid medications during inpatient rehabilitation following traumatic brain injury (TBI). Participants were 248 patients undergoing inpatient rehabilitation care following moderate-to-severe TBI, who underwent level 1 polysomnography (PSG) across 6 TBI Model Systems sites. The PSG sleep parameters included total sleep time (TST), sleep efficiency, wake after sleep onset, rapid eye movement (REM) latency, sleep staging, and arousal and awakening indices. Respiratory measures included oxygen saturation, central apnea events per hour, obstructive apnea and hypopnea events per hour, and total apnea-hypopnea index. After adjustment for number of prescribed medication classes, those receiving opioid medications on the day of PSG experienced increased TST relative to those not receiving opioid medications. Other indices of sleep did not differ significantly between groups. Among respiratory measures those receiving opioids on the day of PSG experienced increased frequency of central sleep apnea events during total and non-REM sleep and higher frequency of obstructive sleep apnea events during REM sleep. Compared with those who did not, receiving opioids was associated with lower oxygen saturation nadir during total sleep and a greater number of oxygen desaturations across REM, non-REM, and total sleep. Greater total apnea-hypopnea index was observed during REM and total sleep for those receiving opioids. Findings indicate that opioid use following moderate-to-severe TBI is associated with an increase in indicators of sleep-related breathing disorders.

Author(s):