Sleep disturbance and its associations with severity of dependence, depression and quality of life among heroin-dependen
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RESEARCH
Open Access
Sleep disturbance and its associations with severity of dependence, depression and quality of life among heroin-dependent patients: a cross-sectional descriptive study Vincent Chin-Hung Chen1,2, Hua Ting3,4, Meng-Huan Wu4,5* , Tsang-Yaw Lin5 and Michael Gossop6
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, substancerelated 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 healthrelated quality of life. Early assessments and interventions for sleep disturbance among patients with heroin dependence are recommended. Keywords: Heroin dependence, Sleep disturbance, Depression, Quality of life
* Correspondence: [email protected] 4 Institude of Medicine, Chung-Shan Medical University, Taichung, Taiwan 5 Ministry of Health and Welfare, Tsaotun Psychiatric Center, 542, No.161, Yu-Pin Rd, Caotun Township, Nan-Tou, Taiwan, Republic of China Full list of author information is available at the end of the article © The Author(s). 2017 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http:/
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