Evaluation of obstructive sleep apnea prevalence and factors associated with sleep disturbances in patients diagnosed with opioid use disorder

Opioid use disorder (OUD) is a chronic condition that may lead to long-term alterations in respiratory physiology and the sleep–wake cycle. This study aimed to evaluate sleep quality and sleep-related breathing disturbances in patients receiving Buprenorphine/Naloxone (B/N) maintenance therapy during remission, to examine associated psychiatric symptoms, and to compare the findings with healthy controls. Twenty-five patients under B/N maintenance therapy and 25 age- and sexmatched healthy controls were included. All participants underwent overnight sleep recording using a Type-3 portable polygraph for respiratory event analysis. Sleep quality was assessed with the Pittsburgh Sleep Quality Index (PSQI), while depression and anxiety levels were measured using the Hamilton Depression (HAM-D) and Hamilton Anxiety (HAM-A) scales. PSQI scores were significantly higher in the B/N treatment group compared with controls (7.28±2.75 vs 4.08±1.47; p<0.001). The Apnea-Hypopnea Index (AHI) was also significantly elevated in the patient group (6.06±4.48 vs 4.00±3.95; p=0.019). According to Obstructive Sleep Apnea Syndrome (OSAS) severity grading, 44.0% (n=11) of patients had no OSAS, 52.0% (n=13) had mild OSAS, and 4.0% (n=1) had moderate OSAS; whereas in the control group, these values were 80.0% (n=20), 16.0% (n=4), and 4.0% (n=1), respectively. HAM-A and HAM-D scores were also significantly higher in the B/N group (p<0.001). This study demonstrates a marked deterioration in sleep quality and sleep architecture among patients receiving B/N maintenance therapy. Elevated PSQI scores, increased AHI severity, and higher OSAS frequency indicate that sleepdisordered breathing is a common accompaniment of B/N treatment and may require clinical attention.