Prevalence of sleep-related symptoms in patients receiving methadone maintenance treatment: a systematic review and meta-analysis.

BACKGROUND

Sleep disturbances are sometimes reported in clinical settings among individuals with opioid use disorder (OUD) receiving methadone maintenance treatment (MMT). Although numerous studies have explored this issue, a systematic assessment of the prevalence of these disturbances is lacking.

METHODS

We searched for trials reporting the prevalence of sleep disturbances in patients with OUD receiving MMT. Studies assessing sleep-related symptoms using a standardized scale were included in a prevalence meta-analysis. All other studies were synthesized narratively and in tabular form.

RESULTS

Thirty-eight articles were included. Thirteen studies assessed the prevalence of poor sleep quality using a Pittsburgh Sleep Quality Index (PSQI) score > 5. Given the high level of heterogeneity among included studies, a prediction interval was calculated, suggesting that the prevalence of poor sleepers in future trials will likely range from 50% to 93%. The weighted prevalence estimate of poor sleepers was 75% (95% CI [61-85%], τ² = 1.34). Sensitivity analyses were performed to investigate heterogeneity among the included studies. Eight of the thirteen studies were rated as having low risk of bias, and the certainty of evidence was found to be moderate. In the narrative synthesis, the reported prevalence of daytime sleepiness ranged from 15% to 50%. In studies using polysomnography or nocturnal polygraphy, patients exhibited significantly reduced sleep efficiency and a high prevalence of sleep apnea syndrome, ranging from 39.1% to 78.3%.

CONCLUSIONS

Our findings indicate that patients receiving MMT often experience poor sleep quality, highlighting the need for systematic attention to sleep issues while taking into account psychosocial vulnerability.

REGISTRATION: CRD42025649687.

CLINICAL TRIAL NUMBER: Not applicable.