Sleep-related impairment among people who use opioids: The critical role of structural vulnerability

IF 3.4 2区 医学 Q2 CLINICAL NEUROLOGY Sleep Health Pub Date : 2024-07-26 DOI:10.1016/j.sleh.2024.07.003
Kristin E. Schneider PhD , Emily M. Martin MHS , Glenna J. Urquhart MPH , Laura N. Sisson PhD, MPH, MSSW , Saba Rouhani PhD , Miles Morris MPH , Adam P. Spira PhD, MA , Susan G. Sherman PhD, MPH
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Abstract

Objective

People who use opioids are vulnerable to sleep disturbances due to a range of factors, including the substances they use and the various structural vulnerabilities they face. We aimed to understand the burden of sleep-related impairment and problems pertaining to sleep context and schedule among people who use opioids.

Methods

We explored sleep quality and problems among a suburban sample of people who use opioids experiencing extensive structural vulnerabilities (N = 170). Participants reported their most urgent concern in the past week (e.g., sleep, drug use, housing), their sleep context, sleep problems, sleep schedules, and scores on the PROMIS Sleep-Related Impairment measure. We then quantified associations between Sleep-Related Impairment scores and sociodemographics and substance use.

Results

Participants were primarily men (66%) and non-Hispanic Black (67%) with a mean age of 42 (SD: 12.1). Many experienced hunger (44%) and literal homelessness (40%). One-quarter (28%) reported that sleep was their most urgent concern in the past week. The most common problems when falling or staying asleep were mental health-related symptoms (81%) and pain/discomfort (32%). Literal homelessness (β = 2.2, 95% CI: 0.6, 3.7), hunger (β = 2.3, 95% CI: 1.0, 3.6), and frequent alcohol use (β = 1.5, 95% CI: 0.2, 2.7) were significantly associated with Sleep-Related Impairment scores.

Conclusions

Homelessness and hunger are associated with sleep-related impairment in people who use opioids. Poor sleep quality, substance use, structural vulnerability, and mental health problems are all interrelated sources of functional impairment in this population. Interventions that address poverty as an underlying cause of sleep-related impairment and provide safe sleeping environments are needed.

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阿片类药物使用者的睡眠障碍:结构脆弱性的关键作用。
目的:使用阿片类药物的人很容易受到睡眠障碍的影响,这是由一系列因素造成的,包括他们使用的药物和他们面临的各种结构性弱点。我们旨在了解使用阿片类药物的人群中与睡眠相关的损伤负担以及与睡眠环境和时间安排相关的问题:我们调查了郊区阿片类药物使用者的睡眠质量和问题,这些人面临着广泛的结构性弱点(N = 170)。参与者报告了他们在过去一周中最迫切的问题(如睡眠、吸毒、住房)、他们的睡眠环境、睡眠问题、睡眠时间安排以及 PROMIS 睡眠相关损害测量的得分。然后,我们对睡眠相关损害评分与社会人口统计学和药物使用之间的关联进行了量化:参与者主要为男性(66%)和非西班牙裔黑人(67%),平均年龄为 42 岁(标准差:12.1)。许多人经历过饥饿(44%)和真正的无家可归(40%)。四分之一(28%)的人表示,睡眠是他们在过去一周中最紧迫的问题。入睡或保持睡眠最常见的问题是精神健康相关症状(81%)和疼痛/不适(32%)。无家可归(β = 2.2,95% CI:0.6,3.7)、饥饿(β = 2.3,95% CI:1.0,3.6)和频繁饮酒(β = 1.5,95% CI:0.2,2.7)与睡眠相关损害得分显著相关:结论:无家可归和饥饿与阿片类药物使用者的睡眠相关损害有关。睡眠质量差、药物使用、结构脆弱性和心理健康问题都是导致这一人群功能受损的相互关联的原因。需要采取干预措施,解决贫困这一睡眠相关障碍的根本原因,并提供安全的睡眠环境。
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来源期刊
Sleep Health
Sleep Health CLINICAL NEUROLOGY-
CiteScore
6.30
自引率
9.80%
发文量
114
审稿时长
54 days
期刊介绍: Sleep Health Journal of the National Sleep Foundation is a multidisciplinary journal that explores sleep''s role in population health and elucidates the social science perspective on sleep and health. Aligned with the National Sleep Foundation''s global authoritative, evidence-based voice for sleep health, the journal serves as the foremost publication for manuscripts that advance the sleep health of all members of society.The scope of the journal extends across diverse sleep-related fields, including anthropology, education, health services research, human development, international health, law, mental health, nursing, nutrition, psychology, public health, public policy, fatigue management, transportation, social work, and sociology. The journal welcomes original research articles, review articles, brief reports, special articles, letters to the editor, editorials, and commentaries.
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