Insomnia among methadone-maintained individuals: the feasibility of collecting home polysomnographic recordings

Sleep disturbance among methadone-maintained patients is highly prevalent. A full understanding of sleep disturbance requires polysomnographic measures along with subjective sleep quality measures. The goal of this study was to describe the authors' experiences in performing at-home unattended polysomnography in this population. Participants had a Pittsburgh Sleep Quality Index score of six or higher, which indicates clinically significant insomnia, and 65% of eligible individuals agreed to enroll. Among 88 participants (53% female, 82% white, and a mean methadone dose of 105 mg/day), each undergoing two nights of home polysomnography, we initiated 165 of a maximum of 176 recordings. Overall, 81.7% of participants provided at least one night of "acceptable" polysomnographic data of at least 4 hours duration. Urine toxicology on polysomnographic nights demonstrated that benzodiazepine use was common. The authors conclude that unattended polysomnography is feasible in a population of individuals receiving methadone maintenance treatment. Polysomnography signal quality and overall study success rates were similar to those in non-substance using populations.