Aims. To explore the possibility that stable MMP patients have sleep-disord
ered breathing (SDB) and abnormal sleep architecture defined by nocturnal s
leep stages and sleep efficiency. Design. Observational. Setting. Regional
Methadone Service and sleep disorders laboratory in a university affiliated
hospital. Participants and measurements. Ten stable MMP patients and nine
normal subjects were assessed clinically and with overnight polysomnography
. Findings. There were no differences in age, sex and body mass index betwe
en the groups. The methadone dose ranged between 50 and 120 mg/day. Six pat
ients had central apnoea index (CAI) greater than 5, four had a CAI greater
than 10 and three of these exhibited periodic breathing. No normal subject
had central sleep apnoea. The patients had lower sleep efficiency (p<0.05)
, less slow wave sleep (p<0.01), less rapid eye movement sleep (p<0.05) and
more Stage 2 sleep (p<0.05) than controls. Conclusions. Stable MMP patient
s have more sleep architecture abnormalities than controls and a higher pre
valence of central sleep apnoea. Further studies are needed to confirm thes
e findings, to delineate the mechanisms for the abnormalities and to assess
whether the SDB is related to sudden death in stable MMP patients. We reco
mmend that MMP patients have awake and sleep respiration assessed to identi
fy those potentially at risk.