P009 The effects of low-dose morphine on sleep and breathlessness in chronic obstructive pulmonary disease

Altree, T; Loffler, K; Toson, B; Currow, D; Eckert, D

P009 The effects of low-dose morphine on sleep and breathlessness in chronic obstructive pulmonary disease

Altree, T Loffler, K Toson, B Currow, D

Eckert, D

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Publisher:: Oxford University Press (OUP)
Publication Type:: Journal Article
Citation:: SLEEP Advances, 2022, 3, (Supplement_1), pp. a34-a34
Issue Date:: 2022-11-09

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Field	Value	Language
dc.contributor.author	Altree, T
dc.contributor.author	Loffler, K
dc.contributor.author	Toson, B
dc.contributor.author	Currow, D https://orcid.org/0000-0003-1988-1250
dc.contributor.author	Eckert, D
dc.date.accessioned	2023-02-02T00:38:25Z
dc.date.available	2023-02-02T00:38:25Z
dc.date.issued	2022-11-09
dc.identifier.citation	SLEEP Advances, 2022, 3, (Supplement_1), pp. a34-a34
dc.identifier.issn	2632-5012
dc.identifier.issn	2632-5012
dc.identifier.uri	http://hdl.handle.net/10453/165819
dc.description.abstract	<jats:title>Abstract</jats:title> <jats:sec> <jats:title>Introduction</jats:title> <jats:p>Low-dose morphine is prescribed for refractory breathlessness in chronic obstructive pulmonary disease (COPD). Preliminary investigations suggest improved perceived sleep quality, although concerns exist regarding opioid-induced sedation. This study assessed the effects of morphine on subjective sleep quality and alertness, and potential links between sleep quality and breathlessness.</jats:p> </jats:sec> <jats:sec> <jats:title>Methods</jats:title> <jats:p>Analysis of sleep questionnaire and breathlessness data at baseline and after one week of low-dose slow-release morphine versus placebo according to a double-blind randomised controlled design was performed. Participants were randomised to placebo, 8mg or 16mg/day oral morphine for one week (before further dose escalation). Epworth Sleepiness Scale (ESS), Karolinska Sleep Score (KSS), Leeds Sleep Evaluation Questionnaire (LSEQ) and breathlessness severity scores were assessed. Dose effects on sleep measures were assessed via linear regression (including baseline sleep measures). Drug effects on the relationship between sleep quality and breathlessness were assessed via linear mixed models with random effects and three-way interaction between sleep measures, dose, and visit.</jats:p> </jats:sec> <jats:sec> <jats:title>Results</jats:title> <jats:p>156 patients were randomised as follows: 8mg, n=55; 16mg, n=51; placebo n=50. Overall, there was a neutral effect of morphine on ESS, KSS, and LSEQ (all p&gt;0.05). Morphine did not modify the relationship between sleep measures and breathlessness.</jats:p> </jats:sec> <jats:sec> <jats:title>Discussion</jats:title> <jats:p>Despite safety concerns, one week of morphine did not negatively impact subjective sleep or daytime alertness measures. There was no clear relationship between morphine’s effects on sleep and next-day breathlessness perception. Objective data assessing sleep and next-day alertness are required to further explore potential links between sleep and breathlessness in people with COPD.</jats:p> </jats:sec>
dc.language	en
dc.publisher	Oxford University Press (OUP)
dc.relation.ispartof	SLEEP Advances
dc.relation.isbasedon	10.1093/sleepadvances/zpac029.082
dc.rights	info:eu-repo/semantics/openAccess
dc.title	P009 The effects of low-dose morphine on sleep and breathlessness in chronic obstructive pulmonary disease
dc.type	Journal Article
utslib.citation.volume	3
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
pubs.organisational-group	/University of Technology Sydney/Faculty of Health/IMPACCT
utslib.copyright.status	open_access	*
dc.date.updated	2023-02-02T00:38:23Z
pubs.issue	Supplement_1
pubs.publication-status	Published
pubs.volume	3
utslib.citation.issue	Supplement_1

Abstract:

Abstract Introduction Low-dose morphine is prescribed for refractory breathlessness in chronic obstructive pulmonary disease (COPD). Preliminary investigations suggest improved perceived sleep quality, although concerns exist regarding opioid-induced sedation. This study assessed the effects of morphine on subjective sleep quality and alertness, and potential links between sleep quality and breathlessness. Methods Analysis of sleep questionnaire and breathlessness data at baseline and after one week of low-dose slow-release morphine versus placebo according to a double-blind randomised controlled design was performed. Participants were randomised to placebo, 8mg or 16mg/day oral morphine for one week (before further dose escalation). Epworth Sleepiness Scale (ESS), Karolinska Sleep Score (KSS), Leeds Sleep Evaluation Questionnaire (LSEQ) and breathlessness severity scores were assessed. Dose effects on sleep measures were assessed via linear regression (including baseline sleep measures). Drug effects on the relationship between sleep quality and breathlessness were assessed via linear mixed models with random effects and three-way interaction between sleep measures, dose, and visit. Results 156 patients were randomised as follows: 8mg, n=55; 16mg, n=51; placebo n=50. Overall, there was a neutral effect of morphine on ESS, KSS, and LSEQ (all p>0.05). Morphine did not modify the relationship between sleep measures and breathlessness. Discussion Despite safety concerns, one week of morphine did not negatively impact subjective sleep or daytime alertness measures. There was no clear relationship between morphine’s effects on sleep and next-day breathlessness perception. Objective data assessing sleep and next-day alertness are required to further explore potential links between sleep and breathlessness in people with COPD.

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