Addiction Sciences Division, Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, 3131 Harvey Avenue, Cincinnati, OH 45229, USA.
Addiction Sciences Division, Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, 3131 Harvey Avenue, Cincinnati, OH 45229, USA.
J Subst Abuse Treat. 2019 Jan;96:53-57. doi: 10.1016/j.jsat.2018.10.011. Epub 2018 Oct 26.
Sleep disturbance may play a role in cocaine use outcomes and, hence, may be a potential therapeutic target for cocaine use disorder (CUD). Research in this area, which has largely relied on resource-intensive polysomnography, would be facilitated by identifying a self-report sleep measure predictive of CUD outcomes and by a better understanding of the mechanisms by which sleep may impact CUD outcomes. This study tested the predictive validity of the Pittsburgh Sleep Quality Index (PSQI), a self-report assessment of past-month sleep quality. To better understand potential mechanisms, mediation models relating sleep disturbance to CUD outcomes were evaluated.
This is a secondary analysis of data from cocaine-dependent (n = 290) participants in a multi-site trial evaluating smoking-cessation treatment for stimulant-dependent patients. The PSQI was collected at baseline; the outcomes of interest were cocaine and drug abstinence at end-of-treatment (weeks 9-10). Potential mediators, measured in weeks 1-8, were: cocaine craving (Brief Substance Craving Scale); and anxiety and depression symptoms (Hospital Anxiety and Depression Scale). Mediation techniques were used to evaluate mediation effects separately and jointly.
The majority of participants (58.3%) had baseline sleep disturbance. Sleep disturbance was not a significant predictor of end-of-treatment abstinence when regressed without consideration of mediators. Cocaine craving, anxiety, and depression were significant mediators, both separately and jointly, of an effect of baseline sleep disturbance on end-of-treatment abstinence.
This exploratory analysis suggests that there may be an indirect relationship between self-reported sleep quality and substance use outcomes in cocaine-dependent patients, mediated by craving, anxiety, and depression.
ClinicalTrials.gov: NCT01077024.
睡眠障碍可能在可卡因使用结果中起作用，因此可能是可卡因使用障碍（CUD）的潜在治疗靶点。该领域的研究主要依赖于资源密集型多导睡眠图，如果能够确定一种预测 CUD 结果的自我报告睡眠测量方法，并更好地了解睡眠可能影响 CUD 结果的机制，那么研究将更加便利。本研究测试了匹兹堡睡眠质量指数（PSQI）的预测效度，PSQI 是一种评估过去一个月睡眠质量的自我报告评估方法。为了更好地理解潜在的机制，评估了睡眠障碍与 CUD 结果的中介模型。
这是一项对评估刺激物依赖患者戒烟治疗的多地点试验中可卡因依赖（n=290）参与者数据的二次分析。PSQI 在基线时收集；感兴趣的结局是治疗结束时（第 9-10 周）的可卡因和药物戒断。在第 1-8 周测量的潜在中介变量包括：可卡因渴求（简短物质渴求量表）；焦虑和抑郁症状（医院焦虑和抑郁量表）。使用中介技术分别和共同评估中介效应。
大多数参与者（58.3%）基线时存在睡眠障碍。在不考虑中介变量的情况下，睡眠障碍与治疗结束时的戒断无关，因此不是显著的预测因子。可卡因渴求、焦虑和抑郁是基线睡眠障碍对治疗结束时戒断的影响的重要中介变量，单独和共同都是如此。
这项探索性分析表明，在可卡因依赖患者中，自我报告的睡眠质量与物质使用结果之间可能存在间接关系，其由渴求、焦虑和抑郁介导。
ClinicalTrials.gov：NCT01077024。
