Sleep quality and associated factors in patients enrolled in a methadone maintenance program in Colombia
Description
Introduction: Opioid use disorder is a growing public health problem. Methadone maintenance programs are effective, but sleep disturbances are common and may affect clinical outcomes. In Latin America, evidence on this issue remains limited. Objective: To describe sleep quality and explore associated factors in patients enrolled in a methadone maintenance program in Colombia. Materials and methods: An observational, descriptive, cross-sectional study was conducted. Patients aged 18 years or older with at least three months in the program were included. Of 91 eligible patients, 81 were included in the analysis. Sleep quality was assessed using the Pittsburgh Sleep Quality Index. Descriptive analysis and bivariate analysis were performed using Poisson regression with robust variance to estimate prevalence ratios. Results: Mean age was 33.3 years, with a predominance of males. The median global sleep quality score was 8 points. Overall, 75.3% of participants had poor sleep quality. Sleep latency was the most affected component. No statistically significant associations were found between sleep quality and the evaluated variables. Discussion: These findings confirm the high frequency of sleep disturbances among patients receiving methadone treatment. The absence of associations may be explained by the sample size, population homogeneity, or unmeasured factors. Conclusions: Poor sleep quality is highly prevalent among patients in methadone maintenance programs, with potential implications for treatment adherence and quality of life. These findings may help inform future interventions targeting sleep disturbances in this population.
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Steps to reproduce
Each row corresponds to one participant. Variables include sociodemographic characteristics (age, sex, educational level, area of residence, type of health insurance), medical and psychiatric comorbidities (coded 1 = present, 0 = absent), concomitant psychoactive substance use (coded 1 = present, 0 = absent), current psychotropic medications, daily methadone dose (mg), the seven Pittsburgh Sleep Quality Index (PSQI) component scores (COMPONENTE 1–COMPONENTE 7), the PSQI global score (PSQI), and the binary sleep-quality classification (CALIDAD: 1 = poor sleep quality, PSQI global > 5; 0 = good sleep quality). Sex is coded 1 = male and 0 = female. Analysis workflow Data import. The dataset is read from the first worksheet of the Excel file. Leading and trailing whitespace is removed from column names. Variable preparation. The outcome (CALIDAD) is treated as a binary numeric variable. Continuous variables (age, methadone dose, PSQI global score) are set as numeric; categorical predictors (sex, educational level, area of residence, health insurance) are set as factors. Descriptive statistics. The normality of continuous variables is assessed with the Shapiro–Wilk test. Normally distributed variables (age) are summarized as mean and standard deviation; non-normally distributed variables (methadone dose, PSQI global score) as median and interquartile range. Categorical variables are summarized as absolute frequencies and percentages. The prevalence of poor sleep quality is computed as the proportion of participants with a PSQI global score greater than 5. PSQI component scores are summarized as median and interquartile range. Bivariate analysis. Crude prevalence ratios (PR) with 95% confidence intervals are estimated for each candidate predictor using Poisson regression models with a log link function and robust (sandwich) variance estimation. This approach was chosen because, for a common binary outcome in cross-sectional data, it produces prevalence ratios that are more appropriate and interpretable than odds ratios obtained from logistic regression. Robust standard errors are obtained with the sandwich package and tested with lmtest::coeftest(). A p-value < 0.05 is considered statistically significant.
Institutions
- Technological University of PereiraRisaralda Department, Pereira