Joint Pain Forum – News you can use!
Extended Release Morphine Sulfate Improves Sleep in Osteoarthritis Patients
June 14, 2007
By Ed Susman
Patients who suffer moderate to severe osteoarthritis pain that is bad
enough to disturb sleep may find both pain relief and sound sleep from
treatment with extended release morphine sulfate (Avinza), researchers
suggested here at the 21st annual meeting of the Associated
Professional Sleep Societies (SLEEP).
"There patients are having sleep disturbances that are as bad as people
with chronic insomnia," said researcher Polly Moore, PhD, director of
sleep research, California Clinical Trials, San Diego, California,
When the pain killer is given to patients with documented pain from
osteoarthritis in the morning when the wake up, the effects of the
extended release morphine sulfate appears to make sleep easier, longer
and more fulfilling.
"We were somewhat surprised how well these patients did in improving
their sleep," said Dr. Moore. "When we did the polysomnography studies
of these patients we were shocked at how badly they were sleeping.
Their percentage of sleep efficiency was around 76% which is the same
level of people who have insomnia complaints," she said.
"It was apparent from their sleep characteristics seen on
polysomnography that they, as a group, were indeed experiencing
significant sleep disruption due to their chronic pain for
osteoarthritis, even while on their current medications," added Dr.
The researchers screened 127 individuals, finding 34 patients who
fulfilled entry criteria - moderate to severe pain caused by
osteoarthritis that was having a profound effect on their ability to
sleep. The report discussed 31 evaluable patients who completed two
After 14 days of therapy, Dr. Moore said that the patients improved
significantly in most area. "Their sleep efficiency increased from
76.5% to 83.8%," she said. While the difference was statistically
significant at the level, she said.
Total sleep time increased from 367 minutes a night - 6
hours and 7 minutes to 402.5 minutes - 6 hours and 42.5 minutes a
REM Sleep latency - the time it took patients to reach a deep sleep - decreased from 113 minutes to 62.5 minutes.
"It is sort of counterintuitive to think that by taking
an opioid medication for pain in the morning that you would have an
improved sleep at night," Dr. Moore said. "However, we have learned
that opioids given at night before bedtime actually tend to interfere
"Overall, this study provides support for the clinical
use of Avinza in chronic non-malignant pain patients who complain of
significant difficulties with sleep. The prescribing physician should
feel confident that pain control in these patients will improve
nighttime sleep quality and will increase total sleep time in patients
who are experiencing sleep disruption due to their chronic pain," she
The study indicated that the 30 mg dose of Avinza was
most successful in increasing sleep efficiency, increasing total sleep
time and decreasing total wake-after-sleep-onset times. Dr. Moore said
the use of Avinza caused no unexpected adverse side effect.
The study was conducted by California Clinical Research for Ligand Pharmaceuticals of San Diego.
Map | CONTACT