Sleep disturbance and its associations with severity of dependence, depression and quality of life among heroin-dependent patients: a cross-sectional descriptive study.
Sleep disturbance is common and may adversely affect treatment outcome, mental health, and quality of life in heroin-dependent patients. Previous studies have focused upon patients receiving treatment. We conducted a cross-sectional descriptive study to explore the 1-month prevalence of sleep disturbance and its associations with socio-demographic, substance-related characteristics, severity of dependence, severity of depression, and quality of life among heroin-dependent patients before entering treatment program.



The sample (n = 514) comprised individuals with heroin dependence attending the methadone maintenance treatment program and the therapeutic community at a psychiatric center in Nantou, Taiwan between 2008 and 2014. Sleep quality was measured using Pittsburgh Sleep Quality Index (PSQI) with a global score greater than 5 indicating sleep disturbance. Centre for Epidemiologic Studies Depression Scale, Severity of Dependence Scale, and World Health Organization Quality of Life-BREF were also approached. T-test, chi-square tests, and multivariate logistic regression were performed to measure associations between variables and sleep disturbance.



The 1-month prevalence of sleep disturbance (PSQI > 5) was 76.3% among 514 subjects with heroin dependence. Heroin users with sleep disturbance had significantly more life events in the previous year, higher rate of unemployment, greater cigarette consumption, more substance related criminal convictions, longer length of heroin use, higher rate of injectors, greater severity of dependence, greater severity of depression, and lower quality of life compared to those without sleep disturbance. Severity of dependence, severity of depression, and physical health domain of quality of life remained significantly associated with sleep disturbance after adjusting for other variables.



Heroin-dependent patients had a high 1-month prevalence of sleep disturbance, and this was associated with greater severity of dependence, greater severity of depression, and poorer physical health-related quality of life. Early assessments and interventions for sleep disturbance among patients with heroin dependence are recommended.
Chang Gung Medical Foundation, Chiayi Chang Gung Memorial Hospital, 613, Chiayi County, Taiwan.|Chang Gung University, 333, Tao-Yuan, Taiwan.
Vincent Chin-Hung
VC
Chen
Department of Physical Medicine and Rehabilitation, Chung-Shan Medical University Hospital, Chung-Shan Medical University, Taichung, Taiwan.|Institude of Medicine, Chung-Shan Medical University, Taichung, Taiwan.
Hua
H
Ting
Institude of Medicine, Chung-Shan Medical University, Taichung, Taiwan. b001089026@tmu.edu.tw.|Ministry of Health and Welfare, Tsaotun Psychiatric Center, 542, No.161, Yu-Pin Rd, Caotun Township, Nan-Tou, Taiwan, Republic of China. b001089026@tmu.edu.tw.
Meng-Huan
0000-0003-1691-6702
MH
Wu
Ministry of Health and Welfare, Tsaotun Psychiatric Center, 542, No.161, Yu-Pin Rd, Caotun Township, Nan-Tou, Taiwan, Republic of China.
Tsang-Yaw
TY
Lin
King's College London, Institute of Psychiatry, London, SE5 8AF, UK.
Michael
M
Gossop
D000328:Adult; D016022:Case-Control Studies; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003863:Depression / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D006556:Heroin Dependence / Q000453:epidemiology*; D006801:Humans; D008297:Male; D015995:Prevalence; D011788:Quality of Life; D012307:Risk Factors; D012893:Sleep Wake Disorders / Q000453:epidemiology*; D013624:Taiwan / Q000453:epidemiology; D055815:Young Adult
Depression; Heroin dependence; Quality of life; Sleep disturbance