美沙酮维持治疗海洛因依赖患者的睡眠特征

目的：分析美沙酮维持治疗（MMT）海洛因依赖患者（HAs）的睡眠特征。方法：采用病例对照研究设计分别从MMT门诊和社区招募603例HAs（病例组）和377例性别年龄匹配的健康居民（对照组）,两组对象完成自编睡眠情况问卷和匹兹堡睡眠质量指数（PSQI）。结果：病例组的睡眠潜伏期[（35.7±34.2）min.vs.（24.5±36.5）min.]和睡眠时间[（9.0±2.3）h vs.（7.8±1.5）h]均长于对照组,而其睡眠效率[（87.5±15.3）%vs.（95.1±17.0）%]低于对照组,同时,病例组PSQI总分及其7个睡眠成份分也均高于对照组[如,PSQI总分：（6.5±3.8）vs.（3.5±2.7）],差异均具有统计学意义（P均≤0.002）;目前无业、服用安眠药、既往吸毒时间≥10年和静脉注射方式吸毒的HAs睡眠问题检出率较高。结论：MMT的HAs入睡潜伏期长和睡眠效率差,睡眠质量各维度均全面下降;无业、安眠药使用和既往的较重的吸毒史可能增加了HAs睡眠问题的发生风险。

SLEEP CHARACTERISTICS OF HEROIN ADDICTS RECEIVING METHADONE MAINTENANCE TREATMENT

Objective： To analyze the sleep characteristics of heroin addicts （HAs） under methadone maintenance treatment （MMT）. Method： By using case -control design, 603 HAs and 377 gender- age matched healthy controls were recruited from MMT outpatients and communities, respectively. All the subjects completed a self - designed sleep questionnaire and Pittsburgh sleep quality index （PSQI）. Results：HAs had longer sleep latency [ （35.7 ±34.2） min. vs. （24.5 ±36.5） min. ] and sleep duration [ （9.0 ± 2.3） h vs. （ 7.8 ± 1.5 ） h ] than controls, but had lower sleep efficiency [ （87.5 ± 15.3） % vs. （95.1 ± 17.0） % ], meanwhile, HAs also scored higher than controls on PSQI and its 7 subscales [ e. g. , PSQI score： （ 6.5 ± 3.8 ） vs. （ 3.5 ±2.7 ） ], all these comparisons were statistically significant （P≤0.002）; HAs, who were unemployed, took hypnotics, had ≥10 years of opiate abuse and injected intravenously with heroin before admission to MMT, had higher prevalence of sleep problem. Conclusion：HAs under MMT have long sleep latency, poor sleep efficiency and impaired sleep quality in all sleep domains. Unemployment, use of hypnotics, longer duration of heroin abuse and intravenous injection of heroin might increase HAs＇ risk for sleep problems.