Department of Internal Medicine, Section of Pulmonary, Critical Care, and Sleep Medicine, Yale School of Medicine, 300 Cedar Street, TAC-455 South, New Haven, CT, 06520, USA.
Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA.
Sleep Breath. 2020 Dec;24(4):1729-1737. doi: 10.1007/s11325-020-02123-z. Epub 2020 Jun 17.
The aim of this study was to evaluate the prevalence and clinical correlates of impaired sleep quality and excessive daytime sleepiness among patients receiving methadone for opioid use disorder (OUD).
Patients receiving methadone (n = 164) completed surveys assessing sleep quality (Pittsburgh Sleep Quality Index [PSQI]), daytime sleepiness (Epworth Sleepiness Scale [ESS]), and related comorbidities. We used bivariate and multivariable linear regression models to evaluate correlates of sleep quality and daytime sleepiness.
Ninety percent of patients had poor sleep quality (PSQI >5), and the mean PSQI was high (11.0 ±4). Forty-six percent reported excessive daytime sleepiness (ESS > 10). In multivariable analyses, higher PSQI (worse sleep quality) was significantly associated with pain interference (coefficient = 0.40; 95% CI = 0.18-0.62; β = 0.31), somatization (coefficient = 2.2; 95% CI = 0.75-3.6; β = 0.26), and negatively associated with employment (coefficient = - 2.6; 95% CI = - 4.9 to - 0.19; β = - 0.17). Greater sleepiness was significantly associated with body mass index (coefficient = 0.32; 95% CI = 0.18-0.46; β = 0.33), and there was a non-significant association between sleepiness and current chronic pain (coefficient = 1.6; 95% CI = 0.26-3.5; β = 0.13; p value = 0.09).
Poor sleep quality and excessive daytime sleepiness are common in patients receiving methadone for OUD. Chronic pain, somatization, employment status, and obesity are potentially modifiable risk factors for sleep problems for individuals maintained on methadone. People with OUD receiving methadone should be routinely and promptly evaluated and treated for sleep disorders.
本研究旨在评估接受美沙酮治疗的阿片类药物使用障碍（OUD）患者睡眠质量受损和日间嗜睡的患病率及临床相关因素。
接受美沙酮治疗的患者（n=164）完成了睡眠质量（匹兹堡睡眠质量指数[PSQI]）、日间嗜睡（Epworth 嗜睡量表[ESS]）和相关合并症的调查问卷。我们使用双变量和多变量线性回归模型来评估睡眠质量和日间嗜睡的相关因素。
90%的患者睡眠质量较差（PSQI>5），PSQI 平均值较高（11.0±4）。46%的患者报告日间嗜睡过多（ESS>10）。多变量分析显示，PSQI 较高（睡眠质量较差）与疼痛干扰显著相关（系数=0.40；95%CI=0.18-0.62；β=0.31），与躯体化显著相关（系数=2.2；95%CI=0.75-3.6；β=0.26），与就业呈负相关（系数=-2.6；95%CI=-4.9 至-0.19；β=-0.17）。嗜睡程度与体重指数显著相关（系数=0.32；95%CI=0.18-0.46；β=0.33），与当前慢性疼痛之间存在非显著关联（系数=1.6；95%CI=0.26-3.5；β=0.13；p 值=0.09）。
接受美沙酮治疗的 OUD 患者睡眠质量差和日间嗜睡较为常见。慢性疼痛、躯体化、就业状况和肥胖可能是美沙酮维持治疗人群睡眠问题的潜在可改变的危险因素。接受美沙酮治疗的 OUD 患者应定期及时评估和治疗睡眠障碍。
