Psychosocial Correlates of Insomnia Symptoms Among Women and Men Receiving Buprenorphine Treatment for Opioid Use Disorder
Abstract
1. Introduction
2. Methods
2.1. Participants and Study Design
2.2. Measures
2.2.1. Insomnia
2.2.2. Psychosocial Factors and Demographics
2.3. Data Analysis
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
- Substance Abuse and Mental Health Services Administration. Key Substance Use and Mental Health Indicators in the United States: Results from the 2021 National Survey on Drug Use and Health; Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration: Rockville, MD, USA, 2021. [Google Scholar]
- Spencer, M.R.; Garnett, M.F.; Miniño, A.M. Drug Overdose Deaths in the United States, 2002–2022; National Center for Health Statistics: Hyattsville, ML, USA, 2023. [Google Scholar]
- Wakeman, S.E.; Larochelle, M.R.; Ameli, O.; Chaisson, C.E.; McPheeters, J.T.; Crown, W.H.; Azocar, F.; Sanghavi, D.M. Comparative Effectiveness of Different Treatment Pathways for Opioid Use Disorder. JAMA Netw. Open 2020, 3, e1920622. [Google Scholar] [CrossRef] [PubMed]
- Whelan, P.J.; Remski, K. Buprenorphine vs Methadone Treatment: A Review of Evidence in Both Developed and Developing Worlds. J. Neurosci. Rural. Pract. 2012, 3, 45–50. [Google Scholar] [CrossRef] [PubMed]
- Langstengel, J.; Yaggi, H.K. Sleep Deficiency and Opioid Use Disorder Trajectory, Mechanisms, and Interventions. Clin. Chest Med. 2022, 43, e1–e14. [Google Scholar] [CrossRef] [PubMed]
- Ellis, J.D.; Mayo, J.L.; Gamaldo, C.E.; Finan, P.H.; Huhn, A.S. Worsening Sleep Quality across the Lifespan and Persistent Sleep Disturbances in Persons with Opioid Use Disorder. J. Clin. Sleep. Med. 2022, 18, 587–595. [Google Scholar] [CrossRef]
- Huhn, A.S.; Finan, P.H. Sleep Disturbance as a Therapeutic Target to Improve Opioid Use Disorder Treatment. Exp. Clin. Psychopharmacol. 2022, 30, 1024–1035. [Google Scholar] [CrossRef]
- Hochheimer, M.; Ellis, J.D.; Strickland, J.C.; Rabinowitz, J.A.; Hobelmann, J.G.; Huhn, A.S. Insomnia Symptoms Are Associated with Return to Use and Non-Fatal Overdose Following Opioid Use Disorder Treatment. Sleep 2024, 48, zsae284. [Google Scholar] [CrossRef]
- White, A.M.; Eglovitch, M.; Parlier-Ahmad, A.B.; Dzierzewski, J.M.; James, M.; Bjork, J.M.; Moeller, F.G.; Martin, C.E. Insomnia Symptoms and Neurofunctional Correlates among Adults Receiving Buprenorphine for Opioid Use Disorder. PLoS ONE 2024, 19, e0304461. [Google Scholar] [CrossRef]
- Hochheimer, M.; Ellis, J.D.; Maher, B.; Strickland, J.C.; Rabinowitz, J.A.; Wolinsky, D.; Huhn, A.S. The Association Between Sleep Disturbances and Perceived Stress in Substance Use Disorder Treatment. J. Clin. Psychiatry 2024, 85, 23m15220. [Google Scholar] [CrossRef]
- Wilkerson, A.K.; McRae-Clark, A.L. A Review of Sleep Disturbance in Adults Prescribed Medications for Opioid Use Disorder: Potential Treatment Targets for a Highly Prevalent, Chronic Problem. Sleep Med. 2021, 84, 142–153. [Google Scholar] [CrossRef]
- Huhn, A.S.; Berry, M.S.; Dunn, K.E. Review: Sex-Based Differences in Treatment Outcomes for Persons with Opioid Use Disorder. Am. J. Addict. 2019, 28, 246–261. [Google Scholar] [CrossRef]
- Pengo, M.F.; Won, C.H.; Bourjeily, G. Sleep in Women Across the Life Span. Chest 2018, 154, 196–206. [Google Scholar] [CrossRef] [PubMed]
- Eglovitch, M.; Parlier-Ahmad, A.B.; Legge, C.; Chithranjan, S.; Kolli, S.; Violante, S.; Dzierzewski, J.M.; Huhn, A.S.; Wilkerson, A.; Martin, C.E. Patient Reported Preferences for Sleep Interventions among Women Receiving Buprenorphine for Opioid Use Disorder. Front. Psychiatry 2023, 14, 1244156. [Google Scholar] [CrossRef] [PubMed]
- Morin, C.M.; Belleville, G.; Bélanger, L.; Ivers, H. The Insomnia Severity Index: Psychometric Indicators to Detect Insomnia Cases and Evaluate Treatment Response. Sleep 2011, 34, 601–608. [Google Scholar] [CrossRef]
- Krzyzanowski, M.C.; Ives, C.L.; Jones, N.L.; Entwisle, B.; Fernandez, A.; Cullen, T.; Darity, W.; Fossett, M.; Remington, P.L.; Taualii, M.; et al. The PhenX Toolkit: Measurement Protocols for Assessment of Social Determinants of Health. Am. J. Prev. Med. 2023, 65, 534. [Google Scholar] [CrossRef]
- Billings, M.E.; Cohen, R.T.; Baldwin, C.M.; Johnson, D.A.; Palen, B.N.; Parthasarathy, S.; Patel, S.R.; Russell, M.; Tapia, I.E.; Williamson, A.A.; et al. Disparities in Sleep Health and Potential Intervention Models: A Focused Review. Chest 2021, 159, 1232–1240. [Google Scholar] [CrossRef]
- Stadtler, H.; Turkson, S.; Eglovitch, M.; Svikis, D.S.; Neigh, G.; Martin, C.E. Post-Traumatic Stress Disorder Symptomatology Is Associated with Insomnia among Women Engaged in Opioid Use Disorder Treatment with Buprenorphine. Arch. Womens Ment. Health 2024, 28, 633–637. [Google Scholar] [CrossRef]
- Chan, K.K.S.; Fung, W.T.W. The Impact of Experienced Discrimination and Self-Stigma on Sleep and Health-Related Quality of Life among Individuals with Mental Disorders in Hong Kong. Qual. Life Res. 2019, 28, 2171–2182. [Google Scholar] [CrossRef]
- Fiddian-Green, A.; Gubrium, A.; Harrington, C.; Evans, E.A. Women-Reported Barriers and Facilitators of Continued Engagement with Medications for Opioid Use Disorder. Int. J. Environ. Res. Public Health 2022, 19, 9346. [Google Scholar] [CrossRef]
- Maina, G.; Marshall, K.; Sherstobitof, J. Untangling the Complexities of Substance Use Initiation and Recovery: Client Reflections on Opioid Use Prevention and Recovery From a Social-Ecological Perspective. Subst. Abus. 2021, 15, 11782218211050372. [Google Scholar] [CrossRef]
- Nwanaji-Enwerem, U.; Redeker, N.S.; O’Connell, M.; Barry, D.; Iheanacho, T.; Knobf, T.M.; Scheinost, D.; Wang, K.; Yaggi, K.; Sadler, L.S. Experiences of Stigma and Discrimination Compounded by Intersecting Identities among Individuals Receiving Medication for Opioid Use Disorder. J. Health Care Poor Underserved 2024, 35, 94–115. [Google Scholar] [CrossRef]
- Azevedo, F.M.; de Morais, N.d.S.; Silva, D.L.F.; Candido, A.C.; Morais, D.D.C.; Priore, S.E.; Franceschini, S.D.C.C. Food Insecurity and Its Socioeconomic and Health Determinants in Pregnant Women and Mothers of Children under 2 Years of Age, during the COVID-19 Pandemic: A Systematic Review and Meta-Analysis. Front. Public Health 2023, 11, 1087955. [Google Scholar] [CrossRef] [PubMed]
- Usha, R.; Caroline, R.; Alina, S. Coverage, Access, and Affordability: Key Findings from the 2017 Kaiser Women’s Health Survey; National Library of Medicine: Bethesda, MD, USA, 2018. [Google Scholar]
- Gannon, M.; McLaughlin, K.; Short, V.; Wu, A.; Inguito, K.; Hand, D.J.; Abatemarco, D.J. Food Insecurity and Psychological Distress Amongst Parenting Women in Treatment for Opioid Use: Identifying Barriers to Nutritional Equity and Implications for Future Intervention Research. Am. J. Health Promot. 2023, 37, 1141–1146. [Google Scholar] [CrossRef]
- Cook, R.R.; Jaworski, E.N.; Hoffman, K.A.; Waddell, E.N.; Myers, R.; Korthuis, P.T.; Vergara-Rodriguez, P. Treatment Initiation, Substance Use Trajectories, and the Social Determinants of Health in Persons Living with HIV Seeking Medication for Opioid Use Disorder. Subst. Abus. 2023, 44, 301–312. [Google Scholar] [CrossRef]
Women N = 78 | Men N = 52 | |||
---|---|---|---|---|
With Insomnia (n = 50) | Without Insomnia (n = 28) | With Insomnia (n = 27) | Without Insomnia (n = 25) | |
Age (mean years ± STD) | 37.8 ± 9.2 | 36.5 ± 9.3 | 43.4 ± 9.5 | 44.5 ± 8.9 |
Race | ||||
White | 32 (64.0%) | 16 (57.1%) | 13 (48.1%) | 11 (44.0%) |
Black | 14 (28.0%) | 9 (32.1%) | 10 (37.0%) | 13 (52.0%) |
Other | 3 (6.0%) | 3 (10.7%) | 4 (14.8%) | 1 (4.0%) |
Insurance | ||||
Public | 44 (88.0%) | 25 (89.3%) | 22 (81.5%) | 20 (80.0%) |
Private | 3 (6.0%) | 3 (10.7%) | 1 (3.7%) | 4 (16.0%) |
Other | 2 (4.0%) | 0 (0%) | 4 (14.8%) | 1 (4.0%) |
Employment status | ||||
Employed | 15 (30.0%) | 7 (25.0%) | 14 (51.9%) | 10 (40.0%) |
Unemployed | 24 (48.0%) | 16 (57.1%) | 11 (40.7%) | 9 (36.0%) |
Disabled | 10 (20.0%) | 5 (17.9%) | 2 (7.4%) | 6 (24.0%) |
Education | ||||
<High school | 7 (14.0%) | 8 (28.6%) | 4 (14.8%) | 9 (36.0%) |
High school/GED equivalent | 24 (48.0%) | 12 (42.9%) | 12 (44.4%) | 10 (40.0%) |
>High school | 18 (36.0%) | 8 (28.6%) | 11 (40.7%) | 6 (24.0%) |
Study Sample Characteristics | Women N = 78 | Men N = 52 | |||||
---|---|---|---|---|---|---|---|
With Insomnia (n = 50) | Without Insomnia (n = 28) | p Value | With Insomnia (n = 27) | Without Insomnia (n = 25) | p Value | ||
Individual factors | Comorbidities | ||||||
Depression | 38 (76.0%) | 20 (71.4%) | 0.657 | 12 (44.4%) | 14 (56.0%) | 0.405 | |
Anxiety/panic | 42 (84.0%) | 19 (67.9%) | 0.098 | 17 (63.0%) | 10 (40.0%) | 0.098 | |
PTSD | 14 (28.0%) | 2 (7.1%) | 0.040 | 4 (14.8%) | 3 (12.0%) | 0.776 | |
Bipolar disorder | 12 (24.0%) | 2 (7.1%) | 0.063 | 3 (11.1%) | 1 (4.0%) | 0.336 | |
Discrimination | |||||||
For subst. use | 44 (88.0%) | 18 (64.3%) | 0.040 | 22 (81.5%) | 17 (68.0%) | 0.569 | |
For gender | 27 (54.0%) | 10 (35.7%) | 0.577 | 7 (25.9%) | 6 (24.0%) | 0.839 | |
For race | 34 (68.0%) | 17 (60.7%) | 0.601 | 19 (70.4%) | 10 (40.0%) | 0.666 | |
Family factors | Socioeconomic status | ||||||
In the last 12 months, did you ever eat less than you felt you should because there wasn’t enough money for food? | 24 (48.0%) | 6 (21.4%) | 0.032 | 15 (55.6%) | 10 (40.0%) | 0.281 | |
In the last 12 months, have you needed to see a doctor, but could not because of cost? | 10 (20.0%) | 1 (3.6%) | 0.075 | 10 (37.0%) | 2 (8.0%) | 0.023 | |
Health literacy Do you ever need help reading hospital materials? | 7 (14.6%) | 1 (3.6%) | 0.238 | 5 (18.5%) | 3 (12.0%) | 0.227 | |
Resources (home, bedroom) Are you worried that in the next 2 months, you may not have stable housing? | 20 (40.0%) | 6 (21.4%) | 0.159 | 11 (40.7%) | 7 (28.0%) | 0.190 | |
Residential Safety and Security Are you afraid you might be hurt in your apartment building or house? | 2 (4.0%) | 2 (7.4%) | 0.424 | 2 (7.4%) | 0 (0%) | 0.382 | |
Access to healthcare In the last 12 months, have you ever had to go without healthcare because you didn’t have a way to get there? | 16 (32.0%) | 2 (7.4%) | 0.043 | 3 (11.1%) | 7 (28.0%) | 0.096 | |
Neighborhood and broader socio-cultural factors | I feel safe walking in my neighborhood, day or night | 38 (76.0%) | 22 (81.5%) | 0.979 | 24 (88.9%) | 21 (84.0%) | 0.692 |
Disclaimer/Publisher’s Note: The statements, opinions and data contained in all publications are solely those of the individual author(s) and contributor(s) and not of MDPI and/or the editor(s). MDPI and/or the editor(s) disclaim responsibility for any injury to people or property resulting from any ideas, methods, instructions or products referred to in the content. |
© 2025 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
Share and Cite
Chithranjan, S.; Eglovitch, M.; Marcus, M.M.; Svikis, D.; Alattar, M.; Martin, C.E. Psychosocial Correlates of Insomnia Symptoms Among Women and Men Receiving Buprenorphine Treatment for Opioid Use Disorder. NeuroSci 2025, 6, 48. https://doi.org/10.3390/neurosci6020048
Chithranjan S, Eglovitch M, Marcus MM, Svikis D, Alattar M, Martin CE. Psychosocial Correlates of Insomnia Symptoms Among Women and Men Receiving Buprenorphine Treatment for Opioid Use Disorder. NeuroSci. 2025; 6(2):48. https://doi.org/10.3390/neurosci6020048
Chicago/Turabian StyleChithranjan, Sajanee, Michelle Eglovitch, Madison M. Marcus, Dace Svikis, Maha Alattar, and Caitlin E. Martin. 2025. "Psychosocial Correlates of Insomnia Symptoms Among Women and Men Receiving Buprenorphine Treatment for Opioid Use Disorder" NeuroSci 6, no. 2: 48. https://doi.org/10.3390/neurosci6020048
APA StyleChithranjan, S., Eglovitch, M., Marcus, M. M., Svikis, D., Alattar, M., & Martin, C. E. (2025). Psychosocial Correlates of Insomnia Symptoms Among Women and Men Receiving Buprenorphine Treatment for Opioid Use Disorder. NeuroSci, 6(2), 48. https://doi.org/10.3390/neurosci6020048