Rodrigo T Martins1,2, David C Currow3, Amy P Abernethy4, Miriam J Johnson5, Barbara Toson1, Danny J Eckert1,2. 1. Neuroscience Research Australia (NeuRA), Randwick, New South Wales, Australia. 2. School of Medical Sciences, University of New South Wales, Sydney, New South Wales, Australia. 3. Discipline, Palliative and Supportive Services, Flinders University, Bedford Park, South Australia, Australia. 4. Department of Medicine, Division on Medical Oncology and the Center for Learning Health Care, Duke Clinical Research Institute, Duke University, Durham, North Carolina, USA. 5. Hull York Medical School, The University of Hull, Hull, UK.
Abstract
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.
RCT Entities:
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.
Authors: David C Currow; Sungwon Chang; Diana Ferreira; Danny J Eckert; David Gonzalez-Chica; Nigel Stocks; Magnus Per Ekström Journal: BMJ Open Date: 2021-08-12 Impact factor: 3.006
Authors: Yasuhiro Yamaguchi; K M Saif-Ur-Rahman; Motoko Nomura; Hiromitsu Ohta; Yoshihisa Hirakawa; Takashi Yamanaka; Satoshi Hirahara; Hisayuki Miura Journal: Int J Environ Res Public Health Date: 2022-04-18 Impact factor: 4.614
Authors: David Currow; Gareth John Watts; Miriam Johnson; Christine F McDonald; John O Miners; Andrew A Somogyi; Linda Denehy; Nicola McCaffrey; Danny J Eckert; Philip McCloud; Sandra Louw; Lawrence Lam; Aine Greene; Belinda Fazekas; Katherine C Clark; Kwun Fong; Meera R Agar; Rohit Joshi; Sharon Kilbreath; Diana Ferreira; Magnus Ekström Journal: BMJ Open Date: 2017-07-17 Impact factor: 2.692