Sleep symptoms common during buprenorphine treatment

Sleep-related symptoms are common among people receiving medications for opioid use disorder (OUD), including buprenorphine. In outpatient addiction treatment, nighttime sleep complaints are often evaluated alongside active medication lists and recent substance exposures. This short report described patient-reported nighttime sleep symptoms and sleep-relevant medication class documentation among adults receiving buprenorphine for OUD. This cross-sectional study used survey data and medical-record abstraction from adults receiving buprenorphine for OUD at an academic addiction clinic from February 2022 to September 2023. Nighttime sleep symptoms were characterized using Insomnia Severity Index items 1-3: difficulty falling asleep, difficulty staying asleep, and waking too early. Participants were categorized as No-Sx, Single-Sx, or Multi-Sx. Sleep-relevant medications documented on the active outpatient medication list were grouped into eight classes. Sample characteristics, nighttime symptom groups, medication class documentation, and urine drug testing results within 30 days were summarized descriptively. Among study participants (n = 136), 72.1% endorsed at least one nighttime sleep symptom. Symptom group distribution was No-Sx (27.9%), Single-Sx (11.0%), and Multi-Sx (61.0%). In the Multi-Sx group, gabapentinoids were most frequently documented (34.9%), followed by sedating antidepressants (26.5%), sedating antihistamines (22.9%), and adrenergic agents (22.9%). Cannabinoids were detected in 46.2% of participants with available urine drug testing results. Nighttime sleep symptoms and sleep-relevant medication documentation were common in this outpatient buprenorphine-treated OUD sample. Findings support routine nighttime sleep symptom assessment, together with medication review and consideration of recent substance exposure, to help identify clinically relevant sleep concerns and inform safer outpatient buprenorphine care. Sleep problems are common among people receiving buprenorphine for opioid use disorder. In routine addiction treatment, clinicians often consider sleep symptoms together with active medications and recent substance use. This is important because some medications used for sleep, pain, anxiety, or other symptoms can cause sedation, and active medication lists may not always show why a medication was prescribed. This study looked at adults receiving buprenorphine for opioid use disorder at an outpatient addiction clinic. Participants reported whether they had difficulty falling asleep, difficulty staying asleep, or waking too early. The study also reviewed active medication lists to identify medication classes that may be relevant to sleep or sedation. Recent urine drug testing results were summarized when available. Most participants reported at least one nighttime sleep symptom, and many reported more than one. Several sleep-relevant or potentially sedating medication classes were documented, especially among participants with multiple nighttime symptoms. Cannabinoids were also commonly detected among participants with available urine drug testing results. These findings support routine sleep symptom assessment and careful medication review in outpatient buprenorphine treatment. They also suggest that clinicians may need to consider recent substance exposures beyond the active medication list when evaluating sleep-related concerns.