Sleep improves when hyperbaric oxygen therapy (HBOT) administered before and after methadone dose reduction for adults with opioid use disorder

Primary author: Raymond Quock
Co-author(s): Marian Wilson; Lillian Skeiky; Karen Stanek; Tamara Odom-Maryon; Devon Hansen; Matthew Layton

Primary college/unit: Arts and Sciences
Campus: Pullman


Up to 80% of adults undergoing medication-assisted treatment for opioid use disorder report reduced sleep quality and quantity [Sharkey et al., Drug Alcohol Depend 113:245-248, 2011]. Earlier we reported that HBOT—100% oxygen at greater-than-atmospheric pressure—reduced signs of naloxone-precipitated withdrawal in morphine-dependent mice [Nicoara et al., Brain Res 1648:434-437, 2016]. To study the effects of HBOT on self-reported and objective measures of sleep in adults with opioid use disorder, 31 participants (11 males, 20 females) were randomized into HBOT (n=17) or control (n=14) arms. HBOT was administered for five consecutive days in 90-min sessions at 2.0 atmospheres absolute in a 12-seat sealed, pressurized chamber. Participants agreed to a 10% reduction in their daily methadone dose or 5 mg, whichever was smaller, on Day 2 after HBOT on Day 1. The PROMIS Sleep Disturbance short form, an assessment of self-reported sleep quality, was the primary sleep measure collected at baseline, and post-HBOT at 1 week, 1 month, and 3 months. For a sub-sample (n=7) of those in the HBOT arm, objective sleep measures were captured one week pre- and post-HBOT via wrist-worn actigraphy. PROMIS results showed that the mean sleep disturbance for the control group increased over time but decreased for the HBOT group. Actigraphy results from the HBOT group showed a ~30-min increase in total sleep time and a 16-min reduction in sleep onset latency post-HBOT. These findings support the hypothesis that sleep quality and quantity can improve when HBOT is administered before and after opioid dose reduction.