OPRM1 Gene Interaction with Sleep in Chronic Pain Patients Treated with Opioids.
Pain Physician
; 22(1): 97-107, 2019 01.
Article
em En
| MEDLINE
| ID: mdl-30700073
ABSTRACT
BACKGROUND:
The experience of chronic non-cancer pain (CNCP) is one of the most common reasons individuals seek medical attention. Patients with CNCP frequently experience concomitant sleep-related problems.OBJECTIVES:
The aim was to evaluate sleep problems in opioid naïve CNCP patients, before and after opioid titration, analyzing the influence of OPRM1 gene variants. STUDYDESIGN:
A prospective, cohort, observational study.SETTING:
This study was performed at the Pain Unit of the Alicante University General Hospital.METHODS:
Pain and Medical Outcomes Study Sleep questionnaire (MOS-Sleep) were assessed at baseline and 3 months after opioid titration in 231 opioid naïve CNCP patients. Sleep data was compared with a matched-control group (n = 64). Morphine equivalent daily doses, adverse events, and drugs prescribed for pain were also registered. OPRM1 polymorphism rs1799971 was analyzed by RT-PCR. Ethics Committee approved the study and results were analyzed by R software.RESULTS:
After 3 months of opioid titration, patients with CNCP (63 ± 14 years, 64% female, VAS 74 ± 17 mm) significantly decreased pain intensity, anxiety and depression, and increased quality of life. Sleep problems were significantly more frequent in females (P = 0.002). Age, quality of life, anxiety, and depression all influenced sleep disturbances and problems indices, which were significantly different from the control group. Furthermore, the OPRM1 118-GG genotype was also associated with significantly lower sleep adequacy, and more sleep problems.LIMITATIONS:
Total number of subjects studied was relatively small and most patients were on other non-opioid centrally-acting medications.CONCLUSIONS:
Opioids decreased CNCP severity, improving patients' psychological areas, and quality of life. However, patients with OPRM1 118-GG genotype indicated an increase in sleep problems and worsening sleep pattern while taking opioids. KEY WORDS OPRM1, pharmacogenetics, MOS-Sleep, opioids, chronic noncancer pain, sleep related problems, sleep problem index SLP-6 and SLP-9.
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Coleções:
01-internacional
Temas:
Cuidados_paliativos
/
Geral
Base de dados:
MEDLINE
Assunto principal:
Sono
/
Receptores Opioides mu
/
Dor Crônica
/
Analgésicos Opioides
Tipo de estudo:
Etiology_studies
/
Incidence_studies
/
Observational_studies
/
Risk_factors_studies
Limite:
Adult
/
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
Pain Physician
Assunto da revista:
PSICOFISIOLOGIA
Ano de publicação:
2019
Tipo de documento:
Article
País de afiliação:
Espanha