Polysomnographic Correlates for the Risk of Relapse in Detoxified Opiate-Misuse Patients

Ahmed Rady,1 Jaidaa Mekky,2 Tarek Moulokheya,1 Ahmed Elsheshai3 1Department of Psychiatry, Alexandria University School of Medicine, Alexandria, Egypt; 2Department of Neurology, Alexandria University School of Medicine, Alexandria, Egypt; 3El Mamoura Psychiatric Hospital, Alexandria, EgyptCorrespond...

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Autores principales:	Rady A, Mekky J, Moulokheya T, Elsheshai A
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2020
Materias:	protracted abstinence heroin opiate polysomnography relapse Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429
Acceso en línea:	https://doaj.org/article/108f7a308b344273a1832f07f0793e9b
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spelling	oai:doaj.org-article:108f7a308b344273a1832f07f0793e9b2021-12-02T15:09:53ZPolysomnographic Correlates for the Risk of Relapse in Detoxified Opiate-Misuse Patients1178-2021https://doaj.org/article/108f7a308b344273a1832f07f0793e9b2020-12-01T00:00:00Zhttps://www.dovepress.com/polysomnographic-correlates-for-the-risk-of-relapse-in-detoxified-opia-peer-reviewed-article-NDThttps://doaj.org/toc/1178-2021Ahmed Rady,1 Jaidaa Mekky,2 Tarek Moulokheya,1 Ahmed Elsheshai3 1Department of Psychiatry, Alexandria University School of Medicine, Alexandria, Egypt; 2Department of Neurology, Alexandria University School of Medicine, Alexandria, Egypt; 3El Mamoura Psychiatric Hospital, Alexandria, EgyptCorrespondence: Ahmed RadyAlexandria University School of Medicine, 29 Nabi Daniel St., Alexandria 21131, EgyptTel +2 01282441053Email ahmed.rady@alexmed.edu.egIntroduction: Substance abuse is a complex issue requiring multi-disciplinary management. Protracted abstinence syndrome leads to persistent discomfort even after detoxification lasting months, resulting in poor sleep duration and quality. Despite being a major contributor to relapse and sleep disturbances, no objective assessment procedures to monitor sleep after the detoxification have been reported. The study aims to assess sleep structure after detoxification via polysomnography and psychometrically assess sleep over the next 6 months in abstinent and relapsing patients.Methods: Sixty successfully detoxified males (35.8 ± 7.3 years) with a history of heroin abuse (DSM-V) (mean composite scores (ASI): 1.3 ± 0.06, 3.48 ± 0.38, 5.45 ± 0.63, 1.2 ± 0.19, 3.93 ± 0.9, and 2.61 ± 0.8 for medical status, employment/support status, alcohol/drugs status, legal status, family/social relationships, and psychiatric status, respectively) were recruited immediately following their detoxification, without giving additional psychoactive substances or medications. Polysomnography was done in the second week following detoxification to allow washout of medications, followed by a monthly sleep assessment through sleep diary and daytime sleepiness using a visual analog scale. Relapse was proved by a urine test. Polysomnographic parameters and ASI subscales for relapsing and non-relapsing participants were compared using a 2-tailed Student’s t-test (p< 0.05).Results: Eighteen participants relapsed by 6 months (12 by 3 months). Only the ASI legal problems score was significantly different for the two groups (p=0.001). The differences were significant for NREM stages I (p=0.001) and II (p=0.002), bilateral limb movement (p=0.009), and arousal indices (p=0.001).Conclusion: Measuring polysomnographic parameters (percentage of NREM I and II, arousal index, and limb movement index) for sleep disturbance in detoxified heroin-abuse patients can be potential predictors for relapse in a 6-month follow-up.Keywords: protracted abstinence, heroin, opiate, polysomnography, relapseRady AMekky JMoulokheya TElsheshai ADove Medical Pressarticleprotracted abstinenceheroinopiatepolysomnographyrelapseNeurosciences. Biological psychiatry. NeuropsychiatryRC321-571Neurology. Diseases of the nervous systemRC346-429ENNeuropsychiatric Disease and Treatment, Vol Volume 16, Pp 3187-3196 (2020)
institution	DOAJ
collection	DOAJ
language	EN
topic	protracted abstinence heroin opiate polysomnography relapse Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429
spellingShingle	protracted abstinence heroin opiate polysomnography relapse Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429 Rady A Mekky J Moulokheya T Elsheshai A Polysomnographic Correlates for the Risk of Relapse in Detoxified Opiate-Misuse Patients
description	Ahmed Rady,1 Jaidaa Mekky,2 Tarek Moulokheya,1 Ahmed Elsheshai3 1Department of Psychiatry, Alexandria University School of Medicine, Alexandria, Egypt; 2Department of Neurology, Alexandria University School of Medicine, Alexandria, Egypt; 3El Mamoura Psychiatric Hospital, Alexandria, EgyptCorrespondence: Ahmed RadyAlexandria University School of Medicine, 29 Nabi Daniel St., Alexandria 21131, EgyptTel +2 01282441053Email ahmed.rady@alexmed.edu.egIntroduction: Substance abuse is a complex issue requiring multi-disciplinary management. Protracted abstinence syndrome leads to persistent discomfort even after detoxification lasting months, resulting in poor sleep duration and quality. Despite being a major contributor to relapse and sleep disturbances, no objective assessment procedures to monitor sleep after the detoxification have been reported. The study aims to assess sleep structure after detoxification via polysomnography and psychometrically assess sleep over the next 6 months in abstinent and relapsing patients.Methods: Sixty successfully detoxified males (35.8 ± 7.3 years) with a history of heroin abuse (DSM-V) (mean composite scores (ASI): 1.3 ± 0.06, 3.48 ± 0.38, 5.45 ± 0.63, 1.2 ± 0.19, 3.93 ± 0.9, and 2.61 ± 0.8 for medical status, employment/support status, alcohol/drugs status, legal status, family/social relationships, and psychiatric status, respectively) were recruited immediately following their detoxification, without giving additional psychoactive substances or medications. Polysomnography was done in the second week following detoxification to allow washout of medications, followed by a monthly sleep assessment through sleep diary and daytime sleepiness using a visual analog scale. Relapse was proved by a urine test. Polysomnographic parameters and ASI subscales for relapsing and non-relapsing participants were compared using a 2-tailed Student’s t-test (p< 0.05).Results: Eighteen participants relapsed by 6 months (12 by 3 months). Only the ASI legal problems score was significantly different for the two groups (p=0.001). The differences were significant for NREM stages I (p=0.001) and II (p=0.002), bilateral limb movement (p=0.009), and arousal indices (p=0.001).Conclusion: Measuring polysomnographic parameters (percentage of NREM I and II, arousal index, and limb movement index) for sleep disturbance in detoxified heroin-abuse patients can be potential predictors for relapse in a 6-month follow-up.Keywords: protracted abstinence, heroin, opiate, polysomnography, relapse
format	article
author	Rady A Mekky J Moulokheya T Elsheshai A
author_facet	Rady A Mekky J Moulokheya T Elsheshai A
author_sort	Rady A
title	Polysomnographic Correlates for the Risk of Relapse in Detoxified Opiate-Misuse Patients
title_short	Polysomnographic Correlates for the Risk of Relapse in Detoxified Opiate-Misuse Patients
title_full	Polysomnographic Correlates for the Risk of Relapse in Detoxified Opiate-Misuse Patients
title_fullStr	Polysomnographic Correlates for the Risk of Relapse in Detoxified Opiate-Misuse Patients
title_full_unstemmed	Polysomnographic Correlates for the Risk of Relapse in Detoxified Opiate-Misuse Patients
title_sort	polysomnographic correlates for the risk of relapse in detoxified opiate-misuse patients
publisher	Dove Medical Press
publishDate	2020
url	https://doaj.org/article/108f7a308b344273a1832f07f0793e9b
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Polysomnographic Correlates for the Risk of Relapse in Detoxified Opiate-Misuse Patients

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