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Sleep quality in heroin addicts under methadone maintenance treatment

  • Wen-Yu Hsu (a1) (a2), Nan-Ying Chiu (a1) (a2) (a3), Jui-Ting Liu (a1), Chieh-Hui Wang (a1) (a2), Ting-Gang Chang (a1), Yi-Cheng Liao (a1) (a2) and Pei-I Kuo (a4)...

Hsu W-Y, Chiu N-Y, Liu J-T, Wang C-H, Chang T-G, Liao Y-C, Kuo 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.

Corresponding author
Dr Nan-Ying Chiu, Department of Psychiatry, Lu-Tung Branch of Changhua Christian Hospital, No. 888 Lu-Tung Road, LuKang Town, Changhua County, Taiwan. Tel: +886 4 7789595 ext. 1133; Fax: +886 4 7769780; E-mail:
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1.Cronin A, Keifer JC, Baghdoyan HA, Lydic R.Opioid inhibition of rapid eye movement sleep by a specific mu receptor agonist. Br J Anaesth 1995;74:188192.
2.Stein MD, Herman DS, Bishop S et al. Sleep disturbances among methadone maintained patients. J Subst Abuse Treat 2004;26:175180.
3.Peles E, Schreiber S, Adelson M.Variables associated with perceived sleep disorders in methadone maintenance treatment (MMT) patients. Drug Alcohol Depend 2006;82: 103110.
4.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;53:737740.
5.Buysse DJ, Reynolds CF III, Monk TH, Berman SR, Kupfer DJ.The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res 1989;28:193213.
6.Tsai PS, Wang SY, Wang MY et al. Psychometric evaluation of the Chinese version of the Pittsburgh Sleep Quality Index (CPSQI) in primary insomnia and control subjects. Qual Life Res 2005;14:19431952.
7.Dimsdale JE, Norman D, DeJardin D, Wallace MS.The effect of opioids on sleep architecture. J Clin Sleep Med 2007;3:3336.
8.Xiao L, Tang YL, Smith AK et al. Nocturnal sleep architecture disturbances in early methadone treatment patients. Psychiatry Res 2010;179:9195.
9.Wong WS, Fielding R.Prevalence of insomnia among Chinese adults in Hong Kong: a population-based study. J Sleep Res 2011;20:117126.
10.Cohen J.A power primer. Psychol Bull 1992;112:155159.
11.Brooner RK, King VL, Kidorf M, Schmidt CW Jr, Bigelow GE.Psychiatric and substance use comorbidity among treatment-seeking opioid abusers. Arch Gen Psychiatry 1997;54:7180.
12.Gelkopf M, Bleich A, Hayward R, Bodner G, Adelson M.Characteristics of benzodiazepine abuse in methadone maintenance treatment patients: a 1 year prospective study in an Israeli clinic. Drug Alcohol Depend 1999;55:6368.
13.Brands B, Blake J, Marsh DC, Sproule B, Jeyapalan R, Li S.The impact of benzodiazepine use on methadone maintenance treatment outcomes. J Addict Dis 2008;27:3748.
14.Eiroa-Orosa FJ, Haasen C, Verthein U, Dilg C, Schafer I, Reimer J.Benzodiazepine use among patients in heroin-assisted vs. methadone maintenance treatment: findings of the German randomized controlled trial. Drug Alcohol Depend 2010;112:226233.
15.Sharkey KM, Kurth ME, 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;113:245248.
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Acta Neuropsychiatrica
  • ISSN: 0924-2708
  • EISSN: 1601-5215
  • URL: /core/journals/acta-neuropsychiatrica
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