Hartwell Emily E, Pfeifer James G, McCauley Jenna L, Moran-Santa Maria Megan, Back Sudie E
Medical University of South Carolina, Department of Psychiatry and Behavioral Sciences, Clinical Neurosciences Division, Charleston, SC 29425, USA; University of California at Los Angeles, Department of Psychology, Los Angeles, CA 90095, USA.
Medical University of South Carolina, Department of Psychiatry and Behavioral Sciences, Clinical Neurosciences Division, Charleston, SC 29425, USA.
Addict Behav. 2014 Oct;39(10):1537-42. doi: 10.1016/j.addbeh.2014.05.025. Epub 2014 Jun 2.
Poor sleep quality has been observed in individuals with substance use disorders and is often a trigger for relapse. To date, little research has investigated sleep quality among individuals with prescription opioid (PO) dependence. The present study aimed to address this gap in the literature by examining subjective and objective sleep disturbances among PO dependent individuals.
Subjects were 68 non-treatment seeking individuals (33 PO dependent, 35 healthy controls). Subjective sleep was assessed with the Pittsburgh Sleep Quality Index (PSQI) and Insomnia Severity Index (ISI). Subjects were admitted for an overnight inpatient hospital stay during which objective sleep data was collected using an actigraphy device. Self-report pain was measured with the Brief Pain Inventory.
Significant group differences in subjective sleep quality were revealed in the PSQI (p<0.01) and ISI (p<0.01). Poor sleep quality (i.e., PSQI total score>5) was identified in 80.6% of the PO group, as compared to 8.8% of the control group (p<.001). Significant group differences in sleep quality were identified in five of six actigraphy variables: total time asleep, sleep efficiency, latency of onset of sleep, total time awake and time mobile. Furthermore, significant associations between pain severity and sleep quality were observed.
Results indicate high rates of sleep impairment and poor sleep quality among PO dependent individuals. Pain severity was significantly correlated with sleep quality. Although preliminary, the findings highlight the importance of assessing and treating sleep disturbances, as well as pain, among patients with PO dependence.
在患有物质使用障碍的个体中观察到睡眠质量较差，且这往往是复发的诱因。迄今为止，很少有研究调查过处方阿片类药物（PO）依赖个体的睡眠质量。本研究旨在通过检查PO依赖个体的主观和客观睡眠障碍来填补这一文献空白。
研究对象为68名未寻求治疗的个体（33名PO依赖者，35名健康对照者）。使用匹兹堡睡眠质量指数（PSQI）和失眠严重程度指数（ISI）评估主观睡眠情况。研究对象被收治入院过夜，期间使用活动记录仪收集客观睡眠数据。使用简明疼痛量表测量自我报告的疼痛情况。
PSQI（p<0.01）和ISI（p<0.01）显示出主观睡眠质量存在显著的组间差异。PO组中80.6%的人睡眠质量较差（即PSQI总分>5），而对照组中这一比例为8.8%（p<.001）。在活动记录仪的六个变量中的五个变量上发现了睡眠质量存在显著的组间差异：总睡眠时间、睡眠效率、入睡潜伏期、总清醒时间和活动时间。此外，观察到疼痛严重程度与睡眠质量之间存在显著关联。
结果表明PO依赖个体中睡眠障碍发生率高且睡眠质量差。疼痛严重程度与睡眠质量显著相关。尽管是初步研究，但这些发现凸显了评估和治疗PO依赖患者睡眠障碍以及疼痛的重要性。
