Huffman Margo, Cloeren Marianne, Ware Orrin D, Frey Jodi J, Greenblatt Aaron D, Mosby Amanda, Oliver Marc, Imboden Rachel, Bazell Alicia, Clement Jean, Diaz-Abad Montserrat
University of Maryland School of Medicine, Baltimore, MD, USA.
Division of Occupational and Environmental Medicine, Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, USA.
Subst Abuse. 2022 May 21;16:11782218221098418. doi: 10.1177/11782218221098418. eCollection 2022.
Patients with opioid use disorder (OUD) face high rates of unemployment, putting them at higher risk of treatment nonadherence and poor outcomes, including overdose death. The objective of this study was to investigate sleep quality and its association with other biopsychosocial risk factors for unemployment in patients receiving opioid agonist treatment (OAT) for OUD.
Using a cross-sectional survey design, participants from 3 OAT programs for OUD completed questionnaires to measure sleep quality (Pittsburgh Sleep Quality Index [PSQI]); pain disability; catastrophic thinking; injustice experience; quality of life; and self-assessed disability. Spearman's rank correlation was used to test for associations between sleep quality and other study variables.
Thirty-eight participants completed the study, with mean age 45.6 ± 10.9 years, 27 (71.1%) males, and 16 (42.1%) reporting a high school diploma/equivalent certification as the highest level of academic attainment. Poor sleep quality (defined as PSQI > 5) was identified in 29 participants (76.3%) and was positively correlated with pain disability ( = 0.657, < .01), self-assessed disability ( = 0.640, < .001), symptom catastrophizing ( = 0.499, < .001), and injustice experience ( = 0.642, < .001), and negatively correlated with quality of life ( = -0.623, < .001).
There was a high prevalence of poor sleep quality in patients with OUD on OAT and this was associated with multiple known risk factors for unemployment. These findings warrant the consideration of regular screening for sleep problems and the inclusion of sleep-related interventions to improve sleep quality, decrease the unemployment rate, and enhance the recovery process for individuals with OUD undergoing OAT.
患有阿片类物质使用障碍（OUD）的患者面临着高失业率，这使他们有更高的不坚持治疗风险以及出现包括过量用药死亡在内的不良后果的风险。本研究的目的是调查接受阿片类激动剂治疗（OAT）的OUD患者的睡眠质量及其与失业的其他生物心理社会风险因素之间的关联。
采用横断面调查设计，来自3个OUD的OAT项目的参与者完成问卷调查，以测量睡眠质量（匹兹堡睡眠质量指数[PSQI]）、疼痛残疾、灾难性思维、不公正经历、生活质量和自我评估的残疾情况。采用Spearman等级相关性分析来检验睡眠质量与其他研究变量之间的关联。
38名参与者完成了研究，平均年龄为45.6±10.9岁，27名（71.1%）为男性，16名（42.1%）报告高中文凭/同等学历证书为最高学历水平。29名参与者（76.3%）被确定为睡眠质量差（定义为PSQI>5），且与疼痛残疾（r=0.657，P<0.01）、自我评估的残疾（r=0.640，P<0.001）、症状灾难化（r=0.499，P<0.001）和不公正经历（r=0.642，P<0.001）呈正相关，与生活质量（r=-0.623，P<0.001）呈负相关。
接受OAT的OUD患者中睡眠质量差的患病率很高，且这与多种已知的失业风险因素相关。这些发现值得考虑对睡眠问题进行定期筛查，并纳入与睡眠相关的干预措施，以改善睡眠质量、降低失业率，并促进接受OAT的OUD患者的康复进程。
