Effects of low dose morphine on perceived sleep quality in patients with refractory breathlessness : a hypothesis generating study

Martins, Rodrigo T.; Currow, David; Abernethy, Amy P.; Johnson, Miriam J.; Toson, Barbara; Eckert, Danny J.

Abstract

© 2015 Asian Pacific Society of Respirology. Background and objective The management of chronic refractory breathlessness is one of the indications for regular low-dose (≤30 mg/24 h) oral sustained release morphine. Morphine may disrupt sleep in some conditions and improve sleep quality in others. This study aimed to determine any signal of regular, low-dose morphine on perceived sleep disruption due to breathlessness and perceived sleep quality. Methods This is a secondary analysis of data from 38 participants with refractory breathlessness (30 male; 33 with COPD) aged 76 ± 0.9 years who completed a double-blind, randomized, placebo-controlled, cross-over study in which they received 20 mg oral sustained release morphine daily and placebo for 4 days each. Participant ratings of sleep disruption due to breathlessness and perceived sleep quality were obtained daily throughout the 8-day trial. Results Perceived sleep disruption due to breathlessness over the 4-day period ranged between 13% and 32% of participants for placebo and 13% and 26% for morphine, decreasing by each day of the study during the morphine arm. Most participants reported 'very good' or 'quite good' sleep throughout the trial and were less likely to perceive poor sleep quality during the morphine arm (odds ratio = 0.55, 95% confidence interval: 0.34-0.88, P = 0.01). Participants who reported decreased breathlessness during the 4 days on morphine were also likely to report improved sleep quality with morphine (P = 0.039). Conclusion Four days of low-dose morphine improved perceived sleep quality in elderly participants with refractory breathlessness. Regular low-dose morphine targeted to reduce refractory breathlessness may yield associated benefits by reducing sleep disruption and improving sleep quality.

Citation

Martins, R. T., Currow, D., Abernethy, A. P., Johnson, M. J., Toson, B., & Eckert, D. J. (2016). Effects of low dose morphine on perceived sleep quality in patients with refractory breathlessness : a hypothesis generating study. Respirology : official journal of the Asian Pacific Society of Respirology, 21(2), 386-391. https://doi.org/10.1111/resp.12681

• Journal Article Type: Article
• Acceptance Date: Aug 24, 2015
• Online Publication Date: Nov 12, 2015
• Publication Date: 2016-02
• Deposit Date: Sep 28, 2015
• Publicly Available Date: Nov 23, 2017
• Journal: Respirology
• Print ISSN: 1323-7799
• Electronic ISSN: 1440-1843
• Publisher: Wiley
• Peer Reviewed: Peer Reviewed
• Volume: 21
• Issue: 2
• Pages: 386-391
• DOI: https://doi.org/10.1111/resp.12681
• Keywords: Opioids, COPD, Sleep-disordered breathing, Sleepiness, Dyspnoea, Controlled clinical trials
• Public URL: https://hull-repository.worktribe.com/output/379308
• Publisher URL: http://onlinelibrary.wiley.com/doi/10.1111/resp.12681/abstract
• Additional Information: Authors' accepted manuscript of article: Martins, R. T., Currow, D. C., Abernethy, A. P., Johnson, M. J., Toson, B. and Eckert, D. J. (2016), Effects of low-dose morphine on perceived sleep quality in patients with refractory breathlessness: A hypothesis generating study. Respirology, 21: 386–391. doi:10.1111/resp.12681