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The effects of buprenorphine depot implants on patient sleep and quality of life: findings from a mixed-methods pilot trial

Abstract Background: Opioid use disorder is a critical public health concern and the negative effects of opioids on sleep may reinforce addiction. The objective of this pilot study was to incorporate objective and subjective measures to examine if implantable buprenorphine altered patient sleep and quality of life after crossover from daily-dosed sublingual buprenorphine (clinicaltrials.gov ID: NCT02896660). Methods: This pilot study utilized patient self-report and actigraphy to measure the effects of buprenorphine on sleep and quality of life. Patients (n = 15) on sublingual buprenorphine treatment continuously wore an actigraphy device on their wrist for 90 days. Patients’ sleep was monitored for 30 days, after which patients were crossed over to implantable buprenorphine and monitored for 60 days. Patients completed self-assessments at baseline, days 30, 60, and 90. Five randomized patients completed a short qualitative interview at day 90. Results: In actigraphy measures, patient sleep and energy level remained constant following crossover to BI. Both before and after crossover patients perceived their sleep to be worse than that measured by actigraphy; however, quality of life improvements were reported, despite no changes in energy level or sleep efficiency. Conclusions: This is the first time clinically stable buprenorphine patients’ sleep has been evaluated with actigraphy in combination with self-report. Self-report data added valuable context to actigraphy findings. Stabilized dose delivery via implant allowed patients to re-frame their recovery experience, creating positive impacts on psychosocial health and quality of life despite no objective difference in sleep.