Sleep in lonely heroin-dependent patients receiving methadone maintenance treatment: longer sleep latency, shorter sleep duration, lower sleep efficiency, and poorer sleep quality.

Hong-Jie Li,Bao-Liang Zhong,Jun-Hong Zhu,Jin Lu,Yan-Min Xu

doi:10.18632/oncotarget.20061

Abstract

Given the socially isolated status of Chinese heroin-dependent patients (HDPs) and the significant association between loneliness and sleep problem in the general population, the impact of loneliness on sleep of HDPs is potentially substantial. The study aimed to test whether loneliness is associated with poor sleep in terms of quantity and quality in a consecutive sample of Chinese HDPs receiving methadone maintenance treatment (MMT). The study participants were 603 HDPs of three MMT clinics in Wuhan, China. Data on socio-demographic and clinical characteristics were collected by a standardized self-administered questionnaire. Sleep outcomes included sleep latency, sleep duration, sleep efficiency, and sleep quality. We measured depressive symptoms, loneliness, and sleep quality by using Zung’s Self-rating Depression Scale, the single-item self-report of loneliness, and the Pittsburgh Sleep Quality Index, respectively. Multiple linear regression was used to examine whether loneliness is independently associated with sleep measures. After controlling for the confounding effects of potential socio-demographic and clinical variables, loneliness was significantly associated with longer sleep latency, shorter sleep duration, lower sleep efficiency, and poorer sleep quality. Loneliness may exacerbate sleep disturbance in Chinese HDPs of MMT clinics. Psychosocial interventions aimed at reducing loneliness in MMT clinics would improve the sleep of HDPs.

Highlights

Sleep disturbance is highly prevalent among heroin-dependent patients (HDPs) [1,2,3]
In comparison with studies using similar definitions of loneliness, this prevalence is much higher than that reported in Chinese rural-to-urban migrant workers (18.3%) and older adults (33%) [13, 17]
The high prevalence of loneliness in HDPs found in this study is concordant with the significantly higher level of loneliness experienced by young MDMA users and individuals with substance use disorder compared with healthy controls [24, 25]

Summary

Introduction

Sleep disturbance is highly prevalent among heroin-dependent patients (HDPs) [1,2,3]. A meta-analysis based on 13 studies with 1857 patients reported a 78.5% prevalence of sleep problem in HDPs [4]. Evidence from empirical studies has shown that, in HDPs, sleep disorder is significantly associated with addiction relapse, multiple drug use, and poorer quality of life [4,5,6,7]. There have been many studies investigating factors that are significantly associated with HDPs’ sleep problem [2,3,4,5, 8,9,10,11], most these studies focused on unmodifiable factors of sleep disturbance among HDPs, such as unemployment, long length of heroin use, and a history of injecting heroin. Very few research has studied factors that can be treated or changed

Methods

Results

Conclusion