0368 Pain Severity as a Moderator of the Association between Prescription Opioid Use and Insomnia Symptoms among Adults with Chronic Pain

Abstract

Introduction: Research documenting the impact of opioid medication on sleep among individuals with chronic pain has been mixed. This study aimed to determine if pain severity moderates the association between opioid dose and insomnia symptoms among adults with insomnia and chronic pain. Methods: Participants (N=199; 95% women; 78% White; mean age=51.5, SD=11.6) completed daily diaries assessing insomnia symptoms and use of opioid pain medication for 14 days. Multiple regression was used to determine if evening pain severity moderates the association between average daily opioid dose and average daily sleep onset latency (SOL), wake after sleep onset (WASO), sleep quality (SQ), or time in bed (TIB). Analyses controlled for gender and use of sleep medication. Results: Opioid dose and pain severity interacted in the prediction of SOL (B=-0.34, SE=0.16, p=.04) and TIB (B=-0.81, SE=0.32, p=.01). Larger opioid dose was associated with longer SOL in the context of mild (B=14.89, SE=4.83, p=.002) to moderate (B=8.49, SE=3.07, p=.01) but not severe pain (B=2.10, SE=3.88, p=.60). Similarly, larger opioid dose was associated with longer TIB in the context of mild (B=31.70, SE=9.40, p