title: Sleep disturbances and pain among individuals with prescription opioid dependence.
abstract: BACKGROUND
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: 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. Electronic address: ehartwell@ucla.edu.
authors.forename: Emily E
authors.initials: EE
authors.lastname: Hartwell
authors.affiliation: Medical University of South Carolina, Department of Psychiatry and Behavioral Sciences, Clinical Neurosciences Division, Charleston, SC 29425, USA.
authors.forename: James G
authors.initials: JG
authors.lastname: Pfeifer
authors.affiliation: Medical University of South Carolina, Department of Psychiatry and Behavioral Sciences, Clinical Neurosciences Division, Charleston, SC 29425, USA.
authors.forename: Jenna L
authors.initials: JL
authors.lastname: McCauley
authors.affiliation: Medical University of South Carolina, Department of Psychiatry and Behavioral Sciences, Clinical Neurosciences Division, Charleston, SC 29425, USA.
authors.forename: Megan
authors.initials: M
authors.lastname: Moran-Santa Maria
authors.affiliation: Medical University of South Carolina, Department of Psychiatry and Behavioral Sciences, Clinical Neurosciences Division, Charleston, SC 29425, USA.
authors.forename: Sudie E
authors.initials: SE
authors.lastname: Back
mesh_terms: D056044:Actigraphy; D000328:Adult; D016022:Case-Control Studies; D015897:Comorbidity; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009293:Opioid-Related Disorders / Q000453:epidemiology*; D010146:Pain / Q000453:epidemiology*; D010147:Pain Measurement; D063487:Prescription Drug Misuse / Q000706:statistics & numerical data*; D012720:Severity of Illness Index; D012893:Sleep Wake Disorders / Q000453:epidemiology* / Q000503:physiopathology; D055815:Young Adult
keywords: Actigraphy; Opiates; Prescription opioids; Sleep; Sleep disturbance