Sleeping problems in Chinese illicit drug dependent subjects

BMC Psychiatry

Tieqiao Liu²  Wei Hao⁵  Xiaogang Chen⁵  Zhijuan Feng⁵  Mei Yang⁴  Bin Jiao¹  Hangtao Cui³  Chang Qi⁵  Guanbai Zhang⁶  Qijian Deng⁵  Haoyu He⁵  Yanhui Liao⁵  Jinsong Tang⁵ 

[1] Department of Neurology, Xiangya Hospital of Central South University, Changsha, Hunan, China;The State Key Laboratory of Medical Genetics, Central South University, Changsha, Hunan, China;Department of Psychiatry, Hunan Brain Hospital, Changsha, Hunan, China;School of Public Health, Central South University, Changsha, Hunan, China;Department of Psychiatry, Institute of Mental Health, the Second Xiangya Hospital of Central South University, 139 Renmin (M) Rd, Changsha 410011, Hunan, P. R. China;Yunnan Institute for Drug Abuse, Kunming, Yunnan, China

关键词: Self-reported survey;    Illicit drug dependent subjects;    Sleep quality;    Sleep problems;   

Others  :  1131637
DOI  :  10.1186/s12888-015-0409-x

 received in 2014-08-05, accepted in 2015-02-10,  发布年份 2015

【 摘 要 】

Background

Illicit drug use/dependence has been recognized as a major problem. Clinical studies demonstrate that poor sleep quality is associated with increased frequency of drug use and relapse. However, few studies have addressed the issue of sleep quality among illicit drug dependent subjects.

Methods

This cross-sectional study explored sleep quality in drug dependent subjects in China. We studied 2178 illicit drug dependent subjects from drug rehabilitation centres in Changsha and 2236 non-drug-using subjects, all of whom completed the self-report Pittsburgh Sleep Quality Index (PSQI).

Results

We found that the prevalence of sleep disturbance was much higher in drug users (68.5%, PSQI >5; specifically, 80.24% in heroin users, 54.16% in methamphetamine users and 81.98% in ketamine users with PSQI >5) than non-users (26.4%, PSQI >5). Drug users had approximately twice the sleep latency than nondrug users (37.7 minutes V.S 18.4 minutes). Although drug users and non-users reported similar sleep duration (about 7.4 hours), drug users showed poorer subjective sleep quality and habitual sleep efficiency. They reported more sleep disturbance and need for sleep medications, more daytime dysfunction and poorer subjective sleep quality compared with nondrug users. The total PSQI score positively correlated with the duration of drug use (rp = 0.164, p < 0.001). We also found a link between sleep problems and cigarette smoking, alcohol drinking, and duration of drug use.

Conclusions

Poor sleep quality is common among illicit drug dependent subjects. Long-term substance users had more sleep problems. Future research aiming at quantifying the benefits of treatment interventions should not neglect the influence of sleep problems. Gaining more insight into the impact of sleep quality on the addiction treatment could also help to target future intervention measures more effectively.

【 授权许可】

   
2015 Tang et al.; licensee BioMed Central.

【 参考文献 】

• [1]Lu L, Wang X: Drug addiction in China. Ann NY Acad Sci 2008, 1141:304-17.
• [2]Zhuang X, Wang Y, Chow EP, Liang Y, Wilson DP, Zhang L: Risk factors associated with HIV/HCV infection among entrants in methadone maintenance treatment clinics in China: a systematic review and meta-analysis. Drug Alcohol Depend 2012, 126:286-95.
• [3]Bruno RM, Palagini L, Gemignani A, Gemignani A, Virdis A, Di Giulio A, et al.: Poor sleep quality and resistant hypertension. Sleep Med 2013, 14:1157-63.
• [4]Chakravorty S, Grandner M, Mavandadi S, Perlis ML, Sturgis EB, Oslin DW: Suicidal ideation in veterans misusing alcohol: relationships with insomnia symptoms and sleep duration. Addict Behav 2014, 39:399-405.
• [5]Ohayon MM, Roth T: What are the contributing factors for insomnia in the general population? J Psychosom Res 2001, 51:745-55.
• [6]Singareddy R, Vgontzas AN, Fernandez-Mendoza J, Liao D, Calhoun S, Shaffer ML, et al.: Risk factors for incident chronic insomnia: a general population prospective study. Sleep Med 2012, 13:346-53.
• [7]Liao Y, Tang J, Liu T, Chen X, Luo T, Hao W: Sleeping problems among Chinese heroin-dependent individuals. Am J Drug Alcohol Abuse 2011, 37:179-83.
• [8]Putnins SI, Griffin ML, Fitzmaurice GM, Dodd DR, Weiss RD: Poor sleep at baseline predicts worse mood outcomes in patients with co-occurring bipolar disorder and substance dependence. J Clin Psychiatry 2012, 73:703-8.
• [9]Morgan PT, Pace-Schott E, Sahul Z, Coric V, Stickgold R, Malison RT: Sleep, sleep-dependent procedural learning and vigilance in chronic cocaine users: evidence for occult insomnia. Drug Alcohol Depend 2006, 82:238-49.
• [10]Puhl MD, Boisvert M, Guan Z, Fang J, Grigson PS: A novel model of chronic sleep restriction reveals an increase in the perceived incentive reward value of cocaine in high drug-taking rats. Pharmacol Biochem Behav 2013, 109C:8-15.
• [11]Brower KJ, Aldrich MS, Robinson EA, Zucker RA, Greden JF: Insomnia, self-medication, and relapse to alcoholism. Am J Psychiatry 2001, 158:399-404.
• [12]Chueh KH, Yang MS, Chen CS, Chiou SM: Poor sleep quality and alcohol use problems among elderly Taiwanese aboriginal women. Int Psychogeriatr 2009, 21:593-9.
• [13]Foster JH, Peters TJ: Impaired sleep in alcohol misusers and dependent alcoholics and the impact upon outcome. Alcohol Clin Exp Res 1999, 23:1044-51.
• [14]Zhabenko N, Wojnar M, Brower KJ: Prevalence and correlates of insomnia in a polish sample of alcohol-dependent patients. Alcohol Clin Exp Res 2012, 36:1600-7.
• [15]Mahfoud Y, Talih F, Streem D, Budur K: Sleep disorders in substance abusers: how common are they? Psychiatry (Edgmont) 2009, 6:38-42.
• [16]Hsu WY, Chiu NY, Liu JT, Wang CH, Chang TG, Liao YC, et al.: Sleep quality in heroin addicts under methadone maintenance treatment. Acta Neuropsychiatr 2012, 24:356-60.
• [17]Peles E, Schreiber S, Domany Y, Sason A, Tene O, Adelson M: Achievement of take-home dose privileges is associated with better-perceived sleep and with cognitive status among methadone maintenance treatment patients. World J Biol Psychiatry 2014, 15:620-8.
• [18]Pasch KE, Latimer LA, Cance JD, Moe SG, Lytle LA: Longitudinal bi-directional relationships between sleep and youth substance use. J Youth Adolesc 2012, 41:1184-96.
• [19]Liao Y, Tang J, Corlett PR, Wang X, Yang M, Chen H, et al.: Reduced dorsal prefrontal gray matter after chronic ketamine use. Biol Psychiatry 2011, 69:42-8.
• [20]Buysse DJ, Reynolds CF 3rd, Monk TH, Berman SR, Kupfer DJ: Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res 1989, 28:193-213.
• [21]Backhaus J, Junghanns K, Broocks A, Riemann D, Hohagen F: Test-retest reliability and validity of the Pittsburgh Sleep Quality Index in primary insomnia. J Psychosom Res 2002, 53:737-40.
• [22]Carpenter JS, Andrykowski MA: Psychometric evaluation of the Pittsburgh Sleep Quality Index. J Psychosom Res 1998, 45:5-13.
• [23]Liu Y, Liu L, Yang Y, He Y, Zhang Y, Wang M, et al. A school-based study of irritable bowel syndrome in medical students in beijing, china: prevalence and some related factors. Gastroenterol Res Pract. 2014, doi:10.1155/2014/124261.
• [24]Liu XC: Pittsburgh Sleep Quality Index. Chin Ment Health J 1999, 13:375-87.
• [25]Ho RT, Fong TC: Factor structure of the Chinese version of the Pittsburgh sleep quality index in breast cancer patients. Sleep Med 2014, 15:565-9.
• [26]Peles E, Schreiber S, Adelson M: Variables associated with perceived sleep disorders in methadone maintenance treatment (MMT) patients. Drug Alcohol Depend 2006, 82:103-10.
• [27]Stein MD, Herman DS, Bishop S, Lassor JA, Weinstock M, Anthony J, et al.: Sleep disturbances among methadone maintained patients. J Subst Abuse Treat 2004, 26:175-80.
• [28]Sharkey KM, Kurth M, Anderson BJ, Corso RP, Millman RP, Stein MD: Assessing sleep in opioid dependence: a comparison of subjective ratings, sleep diaries, and home polysomnography in methadone maintenance patients. Drug Alcohol Depend 2011, 113:245-8.
• [29]Chaput JP, McNeil J, Despres J-P, Bouchard C, Tremblay A: Short sleep duration is associated with greater alcohol consumption in adults. Appetite 2012, 59:650-5.
• [30]Chakravorty SA-O, Jackson N, Chaudhary NA-O, Kozak PJ, Perlis ML, Shue HR, et al. Daytime sleepiness: associations with alcohol use and sleep duration in americans. Sleep Disord. 2014. doi:10.1155/2014/959152.
• [31]Palmer CD, Harrison GA, Hiorns RW: Association between smoking and drinking and sleep duration. Ann Hum Biol 1980, 7:103-7.
• [32]Jaehne A, Unbehaun T, Feige B, Lutz UC, Batra A, Riemann D: How smoking affects sleep: a polysomnographical analysis. Sleep Med 2012, 13:1286-92.
• [33]Fenton MC, Keyes K, Geier T, Greenstein E, Skodol A, Krueger B, et al.: Psychiatric comorbidity and the persistence of drug use disorders in the United States. Addiction 2012, 107:599-609.
• [34]Chakravorty S, Grandner M, Kranzler HR, Mavandadi S, Kling MA, Perlis ML, et al.: Insomnia in alcohol dependence: predictors of symptoms in a sample of veterans referred from primary care. Am J Addict 2013, 22:266-70.
• [35]Rubinstein ML, Luks TL, Moscicki AB, Dryden W, Rait MA, Simpson GV: Smoking-related cue-induced brain activation in adolescent light smokers. J Adolesc Health 2011, 48:7-12.
• [36]Brower KJ, Aldrich M, Hall JM: Polysomnographic and subjective sleep predictors of alcoholic relapse. Alcohol Clin Exp Res 1998, 22:1864-71.
• [37]Soldatos CR, Kales JD, Scharf MB, Bixler EO, Kales A: Cigarette smoking associated with sleep difficulty. Science 1980, 207:551-3.
• [38]Mak KK, Ho SY, Thomas GN, Lo WS, Cheuk DK, Lai YK, et al.: Smoking and sleep disorders in Chinese adolescents. Sleep Med 2010, 11:268-73.
• [39]Fucito LM, Redeker NS, Ball SA, Toll BA, Ikomi JT, Carroll KM: Integrating a behavioural sleep intervention into smoking cessation treatment for smokers with insomnia: a randomised pilot study. J Smok Cessat 2014, 9:31-8.
• [40]Phillips BA, Danner FJ: Cigarette smoking and sleep disturbance. Arch Intern Med 1995, 155:734-7.
• [41]Riedel BW, Durrence H, Lichstein KL, Taylor DJ, Bush AJ: The relation between smoking and sleep: the influence of smoking level, health, and psychological variables. Behav Sleep Med 2004, 2:63-78.
• [42]Brower KJ, Perron BE: Sleep disturbance as a universal risk factor for relapse in addictions to psychoactive substances. Med Hypotheses 2010, 74:928-33.
• [43]Schierenbeck T, Riemann D, Berger M, Hornyak M: Effect of illicit recreational drugs upon sleep: cocaine, ecstasy and marijuana. Sleep Med Rev 2008, 12:381-9.
• [44]Brower KJ: Insomnia, alcoholism and relapse. Sleep Med Rev 2003, 7:523-39.
• [45]Schmutte T, Harris S, Levin R, Zweig R, Katz M, Lipton R: The relation between cognitive functioning and self-reported sleep complaints in nondemented older adults: results from the Bronx aging study. Behav Sleep Med 2007, 5:39-56.