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Berle Gabrielsen K, Clausen T, Håvås Haugland S, Vederhus JK. Gradual improvement in functioning and mental distress during long-term outpatient SUD treatment - A prospective pre-post study. Addict Behav Rep 2024; 19:100525. [PMID: 38273991 PMCID: PMC10808902 DOI: 10.1016/j.abrep.2024.100525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 10/18/2023] [Accepted: 01/02/2024] [Indexed: 01/27/2024] Open
Abstract
Background Globally, outpatient programs for substance use disorder (SUD) treatment have gained prominence. To assess the broader clinical implications of this trend we investigated shifts in functioning experienced by outpatients undergoing treatment. Methods We describe the clinical characteristics of a cohort of 93 SUD patients in a Norwegian outpatient treatment clinic. Using paired-samples t-tests, we examined changes in perceived functioning, mental distress, and other clinically relevant outcome variables in a 5-month time interval during the treatment course. Results We obtained follow-up data for 67 (72%) of the included patients, with no significant difference in patient-related factors between those who completed the treatment course and those who were not assessed at follow-up. Perceived functioning increased significantly from study inclusion (Time 0) (mean 19.8, standard deviation ± 8.8) to its conclusion (Time 1) (24.3, ±9.3; t (66) = 4.5, (95% CI: 2.5-6.5, p < 0.001). We also identified significant improvement in most other measured variables, including mental distress, self-reported sleep quality, restlessness, and obsessive thinking. Substance use-related variables showed a modest, non-significant improvement at T1. Conclusion During a 5-month course of outpatient treatment, patients' subjective experience of functioning improved significantly. Those with the lowest functioning levels at T0 improved the most. Structured monitoring may be a valuable clinical tool for personalizing intervention, enhancing treatment outcomes, and supporting the clinical decision-making process.
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Affiliation(s)
| | - Thomas Clausen
- Addiction Unit, Sørlandet Hospital, Kristiansand, Norway
- Norwegian Centre for Addiction Research (SERAF), University of Oslo, Oslo, Norway
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Yeh YH, Zheng MH, Tegge AN, Athamneh LN, Freitas-Lemos R, Dwyer CL, Bickel WK. The phenotype of recovery XI: associations of sleep quality and perceived stress with discounting and quality of life in substance use recovery. Qual Life Res 2024; 33:1621-1632. [PMID: 38504067 PMCID: PMC11116204 DOI: 10.1007/s11136-024-03625-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/29/2024] [Indexed: 03/21/2024]
Abstract
PURPOSE Sleep and stress show an interdependent relationship in physiology, and both are known risk factors for relapse in substance use disorder (SUD) recovery. However, sleep and stress are often investigated independently in addiction research. In this exploratory study, the associations of sleep quality and perceived stress with delay discounting (DD), effort discounting (ED), and quality of life (QOL) were examined concomitantly to determine their role in addiction recovery. DD has been proposed as a prognostic indicator of SUD treatment response, ED is hypothesized to be relevant to the effort to overcome addiction, and QOL is an important component in addiction recovery. METHOD An online sample of 118 individuals recovering from SUDs was collected through the International Quit and Recovery Registry. Exhaustive model selection, using the Bayesian Information Criterion to determine the optimal multiple linear model, was conducted to identify variables (i.e., sleep quality, perceived stress, and demographics) contributing to the total variance in DD, ED, and QOL. RESULTS After model selection, sleep was found to be significantly associated with DD. Stress was found to be significantly associated with psychological health, social relationships, and environment QOL. Both sleep and stress were found to be significantly associated with physical health QOL. Neither sleep nor stress was supported as an explanatory variable of ED. CONCLUSION Together, these findings suggest sleep and stress contribute uniquely to the process of addiction recovery. Considering both factors when designing interventions and planning for future research is recommended.
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Affiliation(s)
| | - Michelle H Zheng
- Civil and Environmental Engineering Department, University of California, Los Angeles, CA, USA
| | - Allison N Tegge
- Fralin Biomedical Research Institute at VTC, Roanoke, VA, USA
- Department of Statistics, Virginia Tech, Blacksburg, VA, USA
| | - Liqa N Athamneh
- Fralin Biomedical Research Institute at VTC, Roanoke, VA, USA
| | | | - Candice L Dwyer
- Fralin Biomedical Research Institute at VTC, Roanoke, VA, USA
- Department of Psychology, Virginia Tech, Blacksburg, VA, USA
| | - Warren K Bickel
- Fralin Biomedical Research Institute at VTC, Roanoke, VA, USA.
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Gray E, Wilson M, Landis TT, Little-Gott A. "It's Like Your Whole Body Hates You": Experiences of Withdrawal, Distress, and Barriers to Relief Among Adults Receiving Methadone for Opioid Use Disorder. J Addict Nurs 2022; 33:309-316. [PMID: 37140418 DOI: 10.1097/jan.0000000000000497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
ABSTRACT A qualitative descriptive study was conducted concurrent with a larger study investigating the effects of hyperbaric oxygen treatment on withdrawal symptoms for adults receiving daily methadone for opioid use disorder. The aims of this study were to (a) evaluate the perceptions of withdrawal symptoms and sleep characteristics of study participants and (b) explore the experiences of participation in the parent trial of hyperbaric oxygen treatment.Adults with opioid use disorder can experience distressing symptoms related to withdrawal as well as co-occurring symptoms; sleep impairment is frequently reported. Few studies have examined how adults who receive medication for opioid use disorder experience sleep. A preliminary study of adults receiving daily methadone found that withdrawal symptoms were improved after hyperbaric oxygen treatment. This study explores the narrative of opioid users who report their overall experiences with withdrawal and sleep as well as their experiences of hyperbaric therapy.A convenience sample of six participants was recruited, who represented a small subgroup of participants who completed the larger hyperbaric treatment study. Data were collected via semistructured interviews. Data were analyzed using the qualitative content analysis guidelines proposed by Schreier (2012). All participants described poor overall sleep hygiene and disturbed sleep. More than half of the respondents reported improved or eliminated withdrawal symptoms, and all reported improvement in sleep quality after participation in the sleep study.This companion study confirms that subjective sleep disturbance may be prevalent for adults with opioid use disorder. Participants felt the experience of hyperbaric oxygen treatment produced a positive effect on sleep.
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Saffari M, Chen HP, Chang CW, Fan CW, Huang SW, Chen JS, Chang KC, Lin CY. Effects of sleep quality on the association between problematic internet use and quality of life in people with substance use disorder. BJPsych Open 2022; 8:e155. [PMID: 35946067 PMCID: PMC9380240 DOI: 10.1192/bjo.2022.557] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Problematic internet use, especially in people with substance use disorder, may negatively affect their quality of life (QoL). However, it is unclear whether sleep quality is a key mediator in the association between problematic internet use and QoL among people with substance use disorder. AIMS This study aimed to investigate the relationship between problematic internet use and QoL and how sleep quality may mediate the association between these two variables. METHOD Overall, 319 people (85% male) with substance use disorder (mean age 42.2 years, s.d. 8.9) participated in a cross-sectional study in Taiwan. The Smartphone Application-Based Addiction Scale, Bergan Social Media Addiction Scale, Internet Gaming Disorder-Short Form, Pittsburgh Sleep Quality Index and World Health Organization Quality of Life Questionnaire Brief Version were used. RESULTS The prevalence of sleep problems was 56%. There were significant and direct associations between sleep quality and two types of problematic internet use, and between sleep quality and different dimensions of QoL. All types of problematic internet use were significantly and negatively correlated with QoL. Mediated effects of sleep quality in relationships between the different types of problematic internet use and all dimensions of QoL were significant, except for problematic use of social media. CONCLUSIONS Different types of problematic internet use in people with substance use disorder may be directly associated with reduced QoL. Sleep quality as a significant mediator in this association may be an underlying mechanism to explain pathways between problematic internet use and QoL in this population.
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Affiliation(s)
- Mohsen Saffari
- Health Research Center, Lifestyle Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran; and Health Education Department, School of Health, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Hsin-Pao Chen
- Division of Colon and Rectal Surgery, Department of Surgery, E-Da Hospital, Kaohsiung, Taiwan; and School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan
| | - Ching-Wen Chang
- Graduate Institute of Social Work, National Taiwan Normal University, Taipei, Taiwan
| | - Chia-Wei Fan
- Department of Occupational Therapy, AdventHealth University, Florida, USA
| | - Shih-Wei Huang
- Institute of Environmental Toxin and Emerging Contaminant, Cheng Shiu University, Kaohsiung, Taiwan; and Center for Environmental Toxin and Emerging-Contaminant Research, Cheng Shiu University, Kaohsiung, Taiwan
| | - Jung-Sheng Chen
- Department of Medical Research, E-Da Hospital, Kaohsiung, Taiwan
| | - Kun-Chia Chang
- Department of General Psychiatry, Jianan Psychiatric Center, Ministry of Health and Welfare, Tainan, Taiwan; and Department of Natural Biotechnology, Nan Hua University, Chiayi, Taiwan
| | - Chung-Ying Lin
- Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Biostatistics Consulting Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan; and Department of Occupational Therapy, College of Medicine, National Cheng Kung University, Tainan, Taiwan
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Huffman M, Cloeren M, Ware OD, Frey JJ, Greenblatt AD, Mosby A, Oliver M, Imboden R, Bazell A, Clement J, Diaz-Abad M. Poor Sleep Quality and Other Risk Factors for Unemployment Among Patients on Opioid Agonist Treatment. Subst Abuse 2022; 16:11782218221098418. [PMID: 35645566 PMCID: PMC9130817 DOI: 10.1177/11782218221098418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 04/17/2022] [Indexed: 12/01/2022]
Abstract
Purpose: 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. Methods: 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. Results: 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
(r = 0.657, P < .01), self-assessed
disability (r = 0.640, P < .001),
symptom catastrophizing (r = 0.499,
P < .001), and injustice experience
(r = 0.642, P < .001), and negatively
correlated with quality of life (r = −0.623,
P < .001). Conclusions: 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.
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Affiliation(s)
- Margo Huffman
- University of Maryland School of Medicine, Baltimore, MD, USA
| | - Marianne Cloeren
- Division of Occupational and Environmental Medicine, Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Orrin D Ware
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Jodi J Frey
- University of Maryland School of Social Work, Baltimore, MD, USA
| | - Aaron D Greenblatt
- Departments of Psychiatry and Family & Community Medicine, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Amanda Mosby
- University of Maryland School of Social Work, Baltimore, MD, USA
| | - Marc Oliver
- Division of Occupational and Environmental Medicine, Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Rachel Imboden
- University of Maryland School of Social Work, Baltimore, MD, USA
| | - Alicia Bazell
- University of Maryland School of Social Work, Baltimore, MD, USA
| | - Jean Clement
- University of Maryland School of Medicine, Baltimore, MD, USA
| | - Montserrat Diaz-Abad
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, USA
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Ogeil RP, Arunogiri S, Petersen V, Gooden JR, Lubman DI. Sleep disturbance in clients attending a specialist addiction clinic. Am J Addict 2021; 30:539-542. [PMID: 34414636 DOI: 10.1111/ajad.13212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 07/15/2021] [Accepted: 07/31/2021] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Sleep problems are common among clients attending alcohol and drug services, yet the specific components of sleep disturbed by primary drug of concern (PDOC), and their relationships to affective disorder symptoms are unclear. METHODS We examined sleep problems in clients (n = 32) attending a specialist addiction clinic. RESULTS Global sleep quality was rated poor by >90% of participants (particularly disturbances, latency and efficiency components), with significant associations (p < .05) between poor sleep quality and depression (r = .517), anxiety (r = .571) and stress (r = .503). Sleep quality was significantly poorer among those with a nonalcohol PDOC compared with alcohol as PDOC, t(22) = 3.09, p = .005. CONCLUSION AND SCIENTIFIC SIGNIFICANCE Poor sleep is almost ubiquitous among clients attending alcohol and drug services. However, components of sleep quality disturbed differ in terms of PDOC, highlighting the need for individualised sleep interventions.
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Affiliation(s)
- Rowan P Ogeil
- Eastern Health Clinical School, Monash University, Box Hill, Victoria, Australia.,Monash Addiction Research Centre, Frankston, Victoria, Australia.,Turning Point, Eastern Health, Richmond, Victoria, Australia
| | - Shalini Arunogiri
- Eastern Health Clinical School, Monash University, Box Hill, Victoria, Australia.,Monash Addiction Research Centre, Frankston, Victoria, Australia.,Turning Point, Eastern Health, Richmond, Victoria, Australia.,Central Clinical School, Monash Alfred Psychiatry Research Centre (MAPrc), Monash University, Melbourne, Victoria, Australia
| | | | - James R Gooden
- Eastern Health Clinical School, Monash University, Box Hill, Victoria, Australia.,Turning Point, Eastern Health, Richmond, Victoria, Australia.,School of Psychological Sciences, Turner Institute for Brain and Mental Health, Monash University, Clayton, Victoria, Australia
| | - Dan I Lubman
- Eastern Health Clinical School, Monash University, Box Hill, Victoria, Australia.,Monash Addiction Research Centre, Frankston, Victoria, Australia.,Turning Point, Eastern Health, Richmond, Victoria, Australia
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7
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Luca G, Peris L. Sleep Quality and Sleep Disturbance Perception in Dual Disorder Patients. J Clin Med 2020; 9:jcm9062015. [PMID: 32604951 PMCID: PMC7355436 DOI: 10.3390/jcm9062015] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 06/21/2020] [Accepted: 06/25/2020] [Indexed: 12/11/2022] Open
Abstract
Background: Sleep problems are particularly frequent in psychiatric disorders, but their bidirectional intersection is poorly clarified. An especial link between substance use and sleep seems to exist. While dual disorder patients are certainly at higher risk of experiencing sleep problems, very limited research is available today. Methods: Forty-seven dual disorder hospitalized patients were included in this first study. A complete psychiatric evaluation was performed, and sleep habits, patterns and potential disorders were evaluated with specific sleep scales, as well as anxiety. Results: The global prevalence of insomnia symptoms was considerably higher compared with the general population. Different abuse patterns as a function of concurrent psychiatric diagnosis were found, with no significant gender differences. The association between the investigated sleep parameters and any specific substance of abuse was minor. The addict behavior started in more than half of the patients prior to the main psychiatric diagnosis and close to the beginning of sleep problems. Men had a higher prevalence of insomnia symptoms, together with a higher incidence of anxiety. Overall, subjective daytime functioning was not altered as a consequence of poor sleep. Conclusion: Dual disorder patients face significant sleep disturbances, with low sleep quality. The role of sleep in addiction and dual disorders deserves greater research.
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8
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Hoffman NL, Weber ML, Broglio SP, McCrea M, McAllister TW, Schmidt JD. Influence of Postconcussion Sleep Duration on Concussion Recovery in Collegiate Athletes. Clin J Sport Med 2020; 30 Suppl 1:S29-S35. [PMID: 32132474 DOI: 10.1097/jsm.0000000000000538] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To determine whether decreased sleep duration postconcussion influences days to asymptomatic and assessment of performance throughout recovery. DESIGN Prospective. SETTING Institutional Clinical Research Laboratory. PATIENTS Four hundred twenty-three collegiate athletes were diagnosed with concussion. INTERVENTIONS Multidimensional concussion assessment battery was conducted at baseline, within 24 to 48 hours, daily [2-4 days postinjury (PI); symptoms only], once asymptomatic, and after return-to-play. The battery included the following: 22-item symptom checklist, Standardized Assessment of Concussion (SAC), Balance Error Scoring System (BESS), and computerized neurocognitive test [Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT)]. MAIN OUTCOME MEASURES We subtracted baseline sleep duration from 24 to 48 hours postconcussion sleep duration and categorized athletes into the following groups: shorter sleep (≤-1 hour), no change (>-1 hour, <+1 hour), and longer sleep (≥+1 hour). A 1-way analysis of variance (ANOVA) was conducted to compare days to asymptomatic and separate mixed-model ANOVAs to compare total symptom scores, SAC total scores, BESS total error scores, and ImPACT composite scores between sleep categories across time points (α = 0.05). RESULTS Sleep groups did not differ in days to asymptomatic. The shorter sleep group had greater symptom severity than no sleep change and longer sleep groups at 24 to 48 hours (shorter: 39.1 ± 20.7; no change: 25.1 ± 18.4, P = 0.007; longer: 25.7 ± 21.8, P = 0.004), and at 2 to 4 days PI (shorter: 21.8 ± 21.8; no change: 10.5 ± 10.8, P = 0.013; longer: 11.9 ± 14.2, P = 0.007), but did not differ at other time points (ie, asymptomatic and return-to-play). Participants with shorter sleep exhibited slower ImPACT reaction times at 24 to 48 hours (shorter: 0.68 ± 0.14; no change: 0.61 ± 0.09, P = 0.016; and longer: 0.62 ± 0.12, P = 0.028) and asymptomatic time points (shorter: 0.62 ± 0.11; no change: 0.56 ± 0.05; P = 0.015). CONCLUSION Postinjury sleep declines may be associated with symptom severity and worsened reaction time during initial stages of recovery or may be the result of the concussion itself. Clinicians should be aware of alterations in sleep duration and manage appropriately to mitigate initial symptom burden postconcussion.
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Affiliation(s)
- Nicole L Hoffman
- Department of Kinesiology, University of Georgia, Athens, Georgia
- UGA Concussion Research Laboratory, University of Georgia, Athens, Georgia
| | - Michelle L Weber
- Department of Kinesiology, University of Georgia, Athens, Georgia
- UGA Concussion Research Laboratory, University of Georgia, Athens, Georgia
| | - Steven P Broglio
- NeuroTrauma Research Laboratory, University of Michigan Injury Center, University of Michigan, Ann Arbor, Michigan
| | - Michael McCrea
- Departments of Neurosurgery and Neurology, Medical College of Wisconsin, Milwaukee, Wisconsin; and
| | - Thomas W McAllister
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, Indiana
| | - Julianne D Schmidt
- Department of Kinesiology, University of Georgia, Athens, Georgia
- UGA Concussion Research Laboratory, University of Georgia, Athens, Georgia
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9
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Assessment Protocol for Older Adults With Substance Use. J Addict Nurs 2019; 30:242-247. [PMID: 31800514 DOI: 10.1097/jan.0000000000000306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
This quality improvement project focuses on geriatric syndromes in patients 55 years and older admitted to a Minnesota substance abuse treatment center. Age-specific assessments identify abnormal conditions or geriatric syndromes, which prompt earlier nursing and medical interventions. Nursing staff attended a training program that focused on older adults and the use of the Fulmer SPICES tool for patients over the age of 55 years. Pretest and posttest scores showed a positive change in nursing knowledge with an increase in mean test scores of 10.32 (SD = 1.763) to 12.81 (SD = 1.545), p = .000. A 2-month preimplementation and postimplementation chart audit identified changes in assessment findings using the SPICES tool with an increase in adverse outcomes (1.03%) including sleep problems in 75.4% (n = 43) of the target population.
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10
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Factors Associated with Sleep Disorders among Methadone-Maintained Drug Users in Vietnam. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16224315. [PMID: 31698771 PMCID: PMC6887969 DOI: 10.3390/ijerph16224315] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Revised: 10/29/2019] [Accepted: 10/29/2019] [Indexed: 12/18/2022]
Abstract
Sleep quality among heroin-dependent patients receiving methadone maintenance treatment (MMT) is not fully investigated in Vietnam. This study explored the prevalence of poor sleep quality in methadone-maintained patients and associated factors. This cross-sectional included 395 MMT patients at three clinics in Nam Dinh province, Vietnam. The Pittsburgh Sleep Quality Index (PSQI) was employed to measure patients’ sleep quality. Sociodemographic, clinical, behavioral, psychological, and social support characteristics were collected. Multivariate Logistic and Generalized Linear Regression models were applied to identify associated factors. Among 395 patients, 26.6% had poor sleep quality according to the PSQI scale. People having jobs were less likely to have poor sleep quality and lower PSQI scores compared to unemployed patients. Those having spouses had lower PSQI scores than single patients. High depression, anxiety, and stress scores were associated with poor sleep quality and high PSQI scores. A longer duration of MMT increased the likelihood of experiencing poor sleep quality. Patients smoking tobacco daily or concurrently using drugs had lower PSQI scores than those that did not. This study highlights a moderate prevalence of poor sleep quality among Vietnamese MMT patients. Regular evaluation, appropriate psychological management, and social support, as well as the provision of employment opportunities, potentially improve the sleep quality of methadone-maintained patients.
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11
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Yaghubi M, Zargar F. Effectiveness of Mindfulness-based Relapse Prevention on Quality of Life and Craving in Methadone-treated Patients: A Randomized Clinical Trial. ADDICTION & HEALTH 2019; 10:250-259. [PMID: 31263524 PMCID: PMC6593172 DOI: 10.22122/ahj.v10i4.573] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Background Quality of life (QOL) is always considered as a final consequence of clinical trials, interventions, and health care. The results of studies indicate that addiction leads to lower QOL. However, studies have been conducted on the effectiveness of mindfulness-based interventions on improving QOL. The aim of this study was to investigate the efficacy of mindfulness-based relapse prevention (MBRP) on QOL and craving in methadone-treated patients. Methods This study was conducted in Qom, Iran, in 2017. A sample of 70 methadone-treated patients were randomly selected and assigned to two groups (intervention and control). Participants in both groups completed the 36-item Short Form (SF-36) QOL Questionnaire and Craving Beliefs Questionnaire (CBQ) at the beginning of the study (pre-test), 8 weeks after the study (post-test), and two months after the study (follow up). In this study, the experimental group received 8 training sessions on mindfulness prevention, while the control group did not receive general information about addiction and did not receive any psychological intervention. Finally, data of 63 patients were analyzed with the SPSS software, chi-square test, t-test, and repeated-measures ANOVA. Findings The results of repeated-measures ANOVA showed that there was no significant difference between intervention and control groups in the pre-test, but MBRP in the intervention group significantly increased the scores of QOL and decreased the scores of craving, significantly (P < 0.001). Conclusion The findings of present study indicate that MBRP training can increase the psychological and physical health in dependent methadone-treated patients and decrease craving. These findings suggest that mindfulness training can be used as an effective intervention for improving QOL and reducing craving.
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Affiliation(s)
- Mehdi Yaghubi
- Behavioral Sciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Fatemeh Zargar
- Associate Professor, Department of Psychiatry, School of Medicine AND Behavioral Sciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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12
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Dixon LJ, Lee AA, Gratz KL, Tull MT. Anxiety sensitivity and sleep disturbance: Investigating associations among patients with co-occurring anxiety and substance use disorders. J Anxiety Disord 2018; 53:9-15. [PMID: 29127882 DOI: 10.1016/j.janxdis.2017.10.009] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2017] [Revised: 09/26/2017] [Accepted: 10/31/2017] [Indexed: 01/04/2023]
Abstract
Sleep disturbance is a common problem among individuals with anxiety and substance use disorders (SUD). Anxiety sensitivity (AS) is elevated in patients with anxiety disorders and SUD and has been linked to sleep-related problems, including insomnia and somnolence (i.e., daytime sleepiness). We examined the unique roles of AS cognitive, physical, and social concerns in sleep disturbance among a sample of 99 residential SUD patients with anxiety disorders. Clinical levels of insomnia or somnolence were evidenced by 53.5% of the sample. Consistent with predictions, AS physical concerns was significantly associated with insomnia, and AS cognitive concerns was significantly related to insomnia and somnolence. Hierarchical linear regression models were conducted to test the association of AS cognitive and physical concerns with insomnia and somnolence symptoms while controlling for relevant factors. AS cognitive concerns accounted for unique variance, above and beyond withdrawal symptoms, anxiety, and depressive symptoms, in the model examining insomnia symptoms (B=0.30, SE=0.13, p=0.023). Results suggest that AS cognitive concerns may represent an important transdiagnostic mechanism underlying sleep disturbance among individuals with dual diagnosis.
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Affiliation(s)
- Laura J Dixon
- Department of Psychology, University of Mississippi, P.O. Box 1848, University, MS 38677, United States.
| | - Aaron A Lee
- VA Center for Clinical Management Research, Ann Arbor, MI, United States
| | - Kim L Gratz
- Department of Psychology, University of Toledo, 2801 W. Bancroft, Toledo, OH 43606, United States
| | - Matthew T Tull
- Department of Psychology, University of Toledo, 2801 W. Bancroft, Toledo, OH 43606, United States
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13
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Li DJ, Chung KS, Wu HC, Hsu CY, Yen CF. Predictors of sleep disturbance in heroin users receiving methadone maintenance therapy: a naturalistic study in Taiwan. Neuropsychiatr Dis Treat 2018; 14:2853-2859. [PMID: 30464470 PMCID: PMC6208868 DOI: 10.2147/ndt.s177370] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
INTRODUCTION Sleep disturbance is a major health concern for heroin users receiving methadone maintenance treatment (MMT). The present study was aimed to investigate the predictors for new-onset clinically predominant sleep disturbance (CPSD) among heroin users receiving MMT. METHODS This 2-year retrospective study included 152 individuals (127 males and 25 females) with heroin use disorder who visited our MMT clinics for the first time. A univariate Cox proportional hazards regression model (Cox model) was used to estimate the potential factors of subsequent CPSD, followed by a multivariate Cox model to identify significant predictors of CPSD after adjusting for other covariates. RESULTS Twenty-nine (19.1%) participants developed CPSD during the 2-year period. After forward selection in the Cox model, earlier age at onset of heroin exposure (OR=0.95; P=0.044), lower attendance rate (OR =0.04; P=0.03), greater maximum dose of methadone (OR =1.01; P=0.022), and shorter time to maximum methadone dose (OR =0.98; P=0.007) were significantly associated with new-onset CPSD. CONCLUSION We identified predictors that were significantly associated with new-onset CPSD, and clinicians should be aware of sleep disturbance in heroin users receiving MMT with these risk factors. Future studies are necessary to verify our findings and extend the applicability.
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Affiliation(s)
- Dian-Jeng Li
- Department of Addiction Science, Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung, Taiwan.,Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan,
| | - Kuan-Shang Chung
- Department of Addiction Science, Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung, Taiwan
| | - Hung-Chi Wu
- Department of Addiction Science, Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung, Taiwan
| | - Chih-Yao Hsu
- Department of Addiction Science, Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung, Taiwan
| | - Cheng-Fang Yen
- Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan, .,Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan,
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Schubert JR, Todd Arnedt J. Management of Insomnia in Patients with Alcohol Use Disorder. CURRENT SLEEP MEDICINE REPORTS 2017. [DOI: 10.1007/s40675-017-0066-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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15
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Chen VCH, Ting H, Wu MH, Lin TY, Gossop M. Sleep disturbance and its associations with severity of dependence, depression and quality of life among heroin-dependent patients: a cross-sectional descriptive study. SUBSTANCE ABUSE TREATMENT PREVENTION AND POLICY 2017; 12:16. [PMID: 28320448 PMCID: PMC5360025 DOI: 10.1186/s13011-017-0101-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/26/2016] [Accepted: 03/13/2017] [Indexed: 01/07/2023]
Abstract
BACKGROUND 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. METHODS 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. RESULTS 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. CONCLUSION 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.
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Affiliation(s)
- Vincent Chin-Hung Chen
- Chang Gung Medical Foundation, Chiayi Chang Gung Memorial Hospital, 613, Chiayi County, Taiwan.,Chang Gung University, 333, Tao-Yuan, Taiwan
| | - Hua Ting
- 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
| | - Meng-Huan Wu
- Institude of Medicine, Chung-Shan Medical University, Taichung, Taiwan. .,Ministry of Health and Welfare, Tsaotun Psychiatric Center, 542, No.161, Yu-Pin Rd, Caotun Township, Nan-Tou, Taiwan, Republic of China.
| | - Tsang-Yaw Lin
- Ministry of Health and Welfare, Tsaotun Psychiatric Center, 542, No.161, Yu-Pin Rd, Caotun Township, Nan-Tou, Taiwan, Republic of China
| | - Michael Gossop
- King's College London, Institute of Psychiatry, London, SE5 8AF, UK
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16
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Barker LF, Ireland JL, Chu S, Ireland CA. Sleep and its association with aggression among prisoners: Quantity or quality? INTERNATIONAL JOURNAL OF LAW AND PSYCHIATRY 2016; 47:115-121. [PMID: 27156476 DOI: 10.1016/j.ijlp.2016.02.014] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
OBJECTIVE The current paper aims to examine the association between self-reported sleep quality and quantity and how these relate to aggression motivation and hostile cognition in a male prisoner sample. The cognitive component of sleep, namely perception, is consequently a variable of particular interest and one neglected by previous research. METHODS Two independent studies are presented. The first comprised 95 adult male prisoners who completed a sleep quality index along with measures of implicit and explicit aggression. The second study extended this to consider aggression motivation and hostile attribution biases using a sample of 141 young male adult prisoners. RESULTS In study one, sleep quantity and indicators of sleep quality were found not to associate with aggression whereas the perception of poor sleep did; those perceiving poor sleep quality were more likely than those perceiving good sleep to report they had perpetrated aggression in the previous week and to report higher levels of implicit aggression. Study two found that while increased indicators of poor sleep quality were associated with lower prosocial attribution tendencies and higher levels of reactive and proactive aggression, sleep quantity was not associated. The perception of poor quality sleep was important; those perceiving poor sleep were more likely to report higher levels of reactive and proactive aggression than those reporting good sleep. CONCLUSIONS Collectively the studies highlight the importance of accounting for the perception of sleep quality as an important cognitive component in understanding the association between sleep and aggression.
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Affiliation(s)
| | - Jane L Ireland
- Ashworth Research Centre, Mersey Care NHS Trust and University of Central Lancashire, UK.
| | - Simon Chu
- Ashworth Research Centre, Mersey Care NHS Trust and University of Central Lancashire, UK.
| | - Carol A Ireland
- Ashworth Research Centre, Mersey Care NHS Trust and University of Central Lancashire, UK.
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17
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Fatseas M, Kervran C, Auriacombe M. [Sleep disorders and addictions: Impact on quality of life and relapse vulnerability]. Presse Med 2016; 45:1164-1169. [PMID: 26970937 DOI: 10.1016/j.lpm.2016.01.022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2015] [Revised: 01/13/2016] [Accepted: 01/20/2016] [Indexed: 11/15/2022] Open
Abstract
There is a bidirectional association between sleep disorders and addiction. Sleep problems negatively impact the quality of life of subjects with addictions (psychological state, pain perception, drug use). Sleep disorders are associated with a higher risk of relapse among sujects with addiction. The association between sleep disorders and relapse may be related to poor quality of life or to a higher level of craving. Maintaining abstinence and reducing craving episodes among subjects with addiction is the first-line treatment to reduce sleep disorders. Specific interventions focused on sleep disorders are needed when sleep disorders persist during abstinence and may improve global addiction outcome.
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Affiliation(s)
- Mélina Fatseas
- Université de Bordeaux, 33076 Bordeaux cedex, France; SANPsy CNRS USR 3413, Addiction psychiatry Team, 33076 Bordeaux, France; Pôle d'Addictologie, CH Ch. Perrens, CHU de Bordeaux, 33076 Bordeaux, France.
| | - Charlotte Kervran
- Université de Bordeaux, 33076 Bordeaux cedex, France; SANPsy CNRS USR 3413, Addiction psychiatry Team, 33076 Bordeaux, France; Pôle d'Addictologie, CH Ch. Perrens, CHU de Bordeaux, 33076 Bordeaux, France
| | - Marc Auriacombe
- Université de Bordeaux, 33076 Bordeaux cedex, France; SANPsy CNRS USR 3413, Addiction psychiatry Team, 33076 Bordeaux, France; Pôle d'Addictologie, CH Ch. Perrens, CHU de Bordeaux, 33076 Bordeaux, France.
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