Abstract
Sleep quality among heroin-dependent patients receiving methadone maintenance treatment (MMT) is not fully investigated in Vietnam. This study explored the prevalence of poor sleep quality in methadone-maintained patients and associated factors. This cross-sectional included 395 MMT patients at three clinics in Nam Dinh province, Vietnam. The Pittsburgh Sleep Quality Index (PSQI) was employed to measure patients’ sleep quality. Sociodemographic, clinical, behavioral, psychological, and social support characteristics were collected. Multivariate Logistic and Generalized Linear Regression models were applied to identify associated factors. Among 395 patients, 26.6% had poor sleep quality according to the PSQI scale. People having jobs were less likely to have poor sleep quality and lower PSQI scores compared to unemployed patients. Those having spouses had lower PSQI scores than single patients. High depression, anxiety, and stress scores were associated with poor sleep quality and high PSQI scores. A longer duration of MMT increased the likelihood of experiencing poor sleep quality. Patients smoking tobacco daily or concurrently using drugs had lower PSQI scores than those that did not. This study highlights a moderate prevalence of poor sleep quality among Vietnamese MMT patients. Regular evaluation, appropriate psychological management, and social support, as well as the provision of employment opportunities, potentially improve the sleep quality of methadone-maintained patients.
Highlights
Sleep disturbance is a common global health issue given that more than one-third of adults experience this problem during their lifetime [1,2]—a proportion of which may be genetic [3]
There were five maintenance treatment (MMT) clinics operated in the province, and three MMT clinics were randomly selected as study settings, including: (1) Giao Thuy district health center, (2) Dai Dong private health facility, and (3) Giao Thuy Center for Social Evils Prevention
These clinics provide MMT services following the official guidelines of the Vietnam Ministry of Health for at least 12 months
Summary
Sleep disturbance is a common global health issue given that more than one-third of adults experience this problem during their lifetime [1,2]—a proportion of which may be genetic [3]. Prior research found a higher frequency of abnormal cycling patterns of sleep, central sleep apnea, and higher variance of respiratory rate during sleep—reflecting sleep-disordered breathing—among these people compared to the healthy control group [6,7,8]. Another reason might be because using heroin and other opiates could affect the opioid receptor μ-1 (OPRM1), which decreases adenosine concentration levels—an important neurochemical driving factor for sleep, leading to sleep impairment [9,10]. Otherwise, using heroin and other opiates releases acetylcholine in the brain, inhibiting the rapid eye movement (REM) sleep phase, suppressing the transmission of gamma-aminobutyric acid-ergic (GABAergic) in the dorsal raphe nucleus, and resulting in patients’ wakefulness [12,13]
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