美沙酮维持治疗海洛因依赖患者疼痛问题与睡眠的关系

RELATIONSHIP BETWEEN PAIN AND SLEEP IN HEROIN-DEPENDENT PATIENTS RECEIVING METHADONE MAINTENANCE TREATMENT

目的:分析美沙酮维持治疗(MMT)海洛因依赖患者疼痛与睡眠数量和质量的关系。方法:603例MMT门诊海洛因依赖患者完成Zung氏抑郁自评量表和Zung氏焦虑自评量表,并接受疼痛(强度和功能损害)和睡眠(潜伏期、效率和质量)评估;用协方差分析检验疼痛是否与海洛因依赖患者睡眠数量和质量显著相关。结果:MMT海洛因依赖患者一般疼痛和临床显著疼痛检出率分别为64.3%和14.1%;控制协变量后,一般疼痛和临床显著疼痛患者睡眠潜伏期均显著长于无疼痛患者,临床显著疼痛患者睡眠效率均差于一般疼痛和无疼痛患者;临床显著疼痛患者睡眠质量显著差于一般疼痛患者,一般疼痛患者睡眠质量又显著差于无疼痛患者。结论:MMT海洛因依赖患者疼痛问题检出率高,疼痛导致的睡眠启动和/或维持困难可能是MMT海洛因依赖患者睡眠质量恶化的潜在机制。

Objective： To analyze the relationship between pain and quality of sleep among methadone-maintained heroin dependent patients.Methods： Six hundred and three heroin addicts were recruited from methadone maintenance treatment（MMT） outpatient clinics,administered with Zung＇s Self-rating Scale for Depression and Zung＇s Self-rating Scale for Anxiety,and assessed for their pain（intensity and functional impairment） and sleep（latency,efficiency,and quality）. Covariance analysis was used to test whether pain was significantly associated with quantity and quality of sleep in heroin dependent patients.Results：The rates of general and clinically significant pain（CSP） among MMT heroin addicts were 64. 3% and 14. 1%,respectively. After controlling for potential covariates,patients with CSP and general pain had significantly longer sleep latency than those without pain,and patients with CSP had significantly poorer sleep quality than those with general pain and without pain,and patients with general pain had significantly poorer sleep quality than those without pain.Conclusion：Heroin addicts under MMT produce high prevalence of pain. Difficulties in sleep onset and / or maintenance induced by pain is a potential mechanism of deterioration of sleep quality among MMT heroin addicts.