重度大麻使用者的睡眠障碍。
Sleep disturbance in heavy marijuana users.
作者信息
Bolla Karen I, Lesage Suzanne R, Gamaldo Charlene E, Neubauer David N, Funderburk Frank R, Cadet Jean Lud, David Paula M, Verdejo-Garcia Antonio, Benbrook Amy R
机构信息
Department of Neurology, Johns Hopkins Medical Institutions, Bayview Medical Center, Baltimore, MD 21224, USA.
出版信息
Sleep. 2008 Jun;31(6):901-8. doi: 10.1093/sleep/31.6.901.
STUDY OBJECTIVE
To determine if recently abstinent, heavy marijuana (MJ) users show differences in polysomnographic (PSG) measures compared with a drug-free control group.
DESIGN
A group of carefully selected heavy MJ users were chosen for study inclusion and matched to a drug-free control group. Questionnaire data were collected prior to cessation of MJ use. PSG studies were conducted during 2 consecutive nights after discontinuation of MJ use in our core sleep laboratory.
SETTING
Baltimore Maryland, General Clinical Research Center (GCRC) core sleep lab.
PARTICIPANTS
17 heavy MJ users discontinuing MJ use and 14 drug-free controls. Men and women were studied, 18 to 30 years. The MJ users reported no other drug use and alcohol use was negligible in both groups. Urine was positive for metabolites of cannabis only.
MEASUREMENTS AND RESULTS
The MJ users showed differences in PSG measures (lower total sleep times, and less slow wave sleep than the control group) on both nights; they also showed worse sleep efficiency, longer sleep onset, and shorter REM latency than the control group on Night 2. More sleep continuity parameters were significantly worse for the MJ group than the control group on Night 2 versus Night 1, indicating that sleep in the MJ group was relatively worse on Night 2 compared to Night 1. The MJ group did not show improved sleep after an adaptation night as expected. Withdrawal symptoms, craving, and depression did not appear to influence these findings.
CONCLUSIONS
During discontinuation of heavy MJ use, PSG measures of sleep disturbance were detected in MJ users compared with a drug-free control group. While this preliminary study cannot identify the extent to which these group differences were present before abstinence, poor sleep quality either prior to or after MJ discontinuation could result in treatment failure for MJ users. Further investigation is necessary to determine the association between the use and cessation of MJ and sleep disturbance.
研究目的
确定近期戒断的重度大麻使用者与无药物对照组相比，在多导睡眠图（PSG）测量方面是否存在差异。
设计
选择一组经过精心挑选的重度大麻使用者纳入研究，并与无药物对照组进行匹配。在停止使用大麻之前收集问卷数据。在我们的核心睡眠实验室中，于停止使用大麻后的连续两个晚上进行PSG研究。
地点
马里兰州巴尔的摩，综合临床研究中心（GCRC）核心睡眠实验室。
参与者
17名停止使用大麻的重度大麻使用者和14名无药物对照组。研究对象为18至30岁的男性和女性。大麻使用者报告无其他药物使用，两组的酒精使用量均可忽略不计。尿液仅对大麻代谢物呈阳性。
测量与结果
大麻使用者在两个晚上的PSG测量结果均存在差异（总睡眠时间较短，慢波睡眠比对照组少）；在第二晚，他们的睡眠效率也比对照组差，入睡时间更长，快速眼动潜伏期更短。与第一晚相比，大麻使用者组在第二晚的更多睡眠连续性参数明显比对照组差，这表明与第一晚相比，大麻使用者组在第二晚的睡眠相对更差。大麻使用者组并未如预期那样在适应一晚后睡眠得到改善。戒断症状、渴望和抑郁似乎并未影响这些结果。
结论
在重度大麻使用者停止使用期间，与无药物对照组相比，在大麻使用者中检测到了睡眠障碍的PSG测量结果。虽然这项初步研究无法确定这些组间差异在戒断前存在的程度，但在停止使用大麻之前或之后睡眠质量差都可能导致大麻使用者治疗失败。有必要进行进一步调查以确定大麻使用和戒断与睡眠障碍之间的关联。
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