P-I. Sleep quality in heroin addicts under methadone maintenance treatment.Background: Sleep disturbance is a common phenomenon among opiate addicts. The side effects of opiate addiction or opiate withdrawal might result in sleep disturbance. However, their problems might be related to sedative medication abuse, alcohol abuse or heroin relapse. Sleep is an important issue in this population. Objective: To evaluate the prevalence of sleep disorders in heroin addicts receiving methadone maintenance treatment (MMT) and analyse the correlation between related factors, such as age at opiate exposure, opiate exposure duration, duration in MMT, methadone current dosage, methadone attendance rate and the severity of sleep disorders. Method: We enrolled 121 heroin addicts who were receiving MMT. We collected data on the duration of insomnia, hypnotic history, Visual Analogue Scale-10 of sleep quality, Pittsburgh Sleep Quality Index (PSQI), methadone dosage, methadone history and opiate history. Results: The mean of the PSQI was 9.1 ± 5.4, and 70.2% of patients had PSQI scores >5, indicating they were poor sleepers. We also found the PSQI scores were correlated significantly with the methadone dosage. Conclusions: The sleep disturbance prevalence rate of opiate addicts under MMT was high in Taiwan, as shown in the previous studies, and the severity of sleep disturbance has been underestimated. Significant outcomes• About 70.2% of heroin addicts in methadone maintenance treatment had a sleep disorder in our survey. • The severity of sleep disorder in our survey was a mean of Pittsburgh Sleep Quality Index (PSQI) 9.1 ± 5.4. • PSQI scores were correlated significantly with the methadone dosage. Limitations• Lack of polysomnography to provide objective sleep evaluation. • Limited data on the patients' abuse of hypnotics, alcohol and other substance. • Our samples were from only one site. • The sample size was small.

INTRODUCTIONObstructive sleep apnea (OSA) is a serious sleep disorder characterized by repetitive episodes of paused or shallow breathing during sleep. Patients with OSA often have excessive daytime sleepiness. The role of cigarette smoking in OSA remains controversial. The aim of this study was to examine the relationship between cigarette smoking and OSA.METHODSIn this retrospective chart review, we reviewed 18-month sleep laboratory charts in central Taiwan. We collected data regarding sleep, current cigarette smoking status, sex, age, body mass index (BMI), neck circumference, Epworth Sleepiness Scale score, and polysomnographic sleep parameters. In total, 733 subjects were recruited; among these, 151 were smokers and 582 were non-smokers.RESULTSSmokers had significantly higher apnea–hypopnea index (p<0.001) for non-rapid eye movement sleep stage, higher apnea–hypopnea index (p<0.001) for total sleep time, and higher snore frequency (p<0.001) in t-test analysis. They also demonstrated higher Epworth Sleepiness Scale scores, shorter sleep times, lower percentage of slow-wave (deep) sleep, and longer snore times. However, no significant association was found between cigarette smoking and OSA after adjusting for sex, age, and BMI (OR=1.02, 95% CI: 0.66–1.57).CONCLUSIONSWe did not find any significant association between cigarette smoking and OSA after adjusting for age, sex, and BMI. Further well-designed prospective controlled cohort studies might clarify the relationship between cigarette smoking and OSA.

Background Demoralization is a common problem in oral cancer patients owing to the chronic and severe nature of their affliction. However, the association between demoralization and the patient’s spiritual needs, quality of life, and suicidal ideation remains unclear. This study aims to provide insights into possible links between demoralization among oral cancer patients and its effects on the patient’s spiritual needs, quality of life, and suicidal ideation. Methods We examined 155 Taiwanese oral cancer inpatients in Taichung Veterans General Hospital, Taiwan, using the following three rating scales: (a) Demoralization Scale Mandarin Version (DS-MV), (b) Spiritual Interests Related to Illness Tool, and (c) The Taiwan Chinese versions of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire. Suicidal ideation was established if at least one of the two suicide-related items on the DS-MV scale were checked. We divided the participants into high- and low-demoralization groups, per the cutoff score of 30. We then explored group associations with sociodemographic features, quality of life, and spiritual needs. Logistic regression and receiver operating characteristic (ROC) curves were used to determine demoralization and its association between these variables. Results Fifty-five (35.5%) patients were categorized as having high demoralization (DS-MV scale score > 30), with scores for DS-MV for all patients being 27.2 ± 16.8. The rates of suicidal ideation were 29.1% (16/55) in the high-demoralization group and 2% (2/100) in the low-demoralization group, with an odds ratio (95% confidence interval) of 20.10 (4.41–91.55). Logistic regression analysis revealed significant effects of spiritual needs and global health status on the DS-MV scores (p < 0.001). Multivariate analyses further confirmed that only overall quality of life scores < 62.5 and spiritual needs < 3.7 significantly predicted the occurrence of high demoralization. Conclusion High demoralization is associated with low satisfaction with spiritual needs, poor quality of life, and high risk of suicidal ideation. DS-MV may potentially be an effective tool for achieving holistic health care among oral cancer patients.

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