Sleep in lonely heroin-dependent patients receiving methadone maintenance treatment: longer sleep latency, shorter sleep duration, lower sleep efficiency, and poorer sleep quality

Abstract

Given the socially isolated status of Chinese heroin-dependent patients (HDPs) and the significant association between loneliness and sleep problem in the general population, the impact of loneliness on sleep of HDPs is potentially substantial. The study aimed to test whether loneliness is associated with poor sleep in terms of quantity and quality in a consecutive sample of Chinese HDPs receiving methadone maintenance treatment (MMT). The study participants were 603 HDPs of three MMT clinics in Wuhan, China. Data on socio-demographic and clinical characteristics were collected by a standardized self-administered questionnaire. Sleep outcomes included sleep latency, sleep duration, sleep efficiency, and sleep quality. We measured depressive symptoms, loneliness, and sleep quality by using Zung’s Self-rating Depression Scale, the single-item self-report of loneliness, and the Pittsburgh Sleep Quality Index, respectively. Multiple linear regression was used to examine whether loneliness is independently associated with sleep measures. After controlling for the confounding effects of potential socio-demographic and clinical variables, loneliness was significantly associated with longer sleep latency, shorter sleep duration, lower sleep efficiency, and poorer sleep quality. Loneliness may exacerbate sleep disturbance in Chinese HDPs of MMT clinics. Psychosocial interventions aimed at reducing loneliness in MMT clinics would improve the sleep of HDPs.

Opioid use disorder and its association with self‐reported difficulties participating in social activities

“…Among those with OUD, difficulties participating in social activities were associated with suicidal ideation but not suicide attempts. The association of OUD and difficulties participating in social activities is consistent with previous research that indicates a positive association between social problems and opioid use 13,16–24 . Our study expands on this work by investigating difficulties participating in social activities across a range of individuals with OUD, rather than only in a treatment‐engaged sample.…”

“…Consistent with this, individuals receiving medications for OUD reported poorer social functioning relative to age‐ and gender‐matched people from the community, which was associated with the perception of being targets of stereotyped attitudes 15 . Furthermore, individuals being treated for heroin use who report loneliness endorse nonsuicidal self‐injury, sleep disturbance, more pain, and poorer quality of life relative to those who do not report loneliness 16–19 . Social isolation is also associated with an increased risk of suicide attempts among individuals using heroin 20–22 .…”

“…Moreover, opioid use may push social support away and social contact may be less rewarding for individuals with OUD 8 . Social difficulties, such as loneliness, also impact risk factors of relapse, such as sleep disturbance and pain 16–19 . As a result, people may use opioids to cope with pain or to help them sleep, thereby maintaining use, particularly when feeling lonely 33 .…”

Factors Associated with Sleep Disorders among Methadone-Maintained Drug Users in Vietnam

“…These disparities might be attributable to different study design characteristics, such as sampling technique (i.e., random sampling or convenient sampling) or clinical features (i.e., inpatients or ambulatory patients). Moreover, several characteristics of our sample would be different such as unemployment rate [37], social support or loneliness [38], anxiety, depression, and stress [39,40], which are potential confounding factors. In this study, we observed a high proportion of patients having spouse/sex partners and receive support from family members (77.7%), which might reduce the risk of poor sleep quality in our patients [21,32,41].…”