Is a History of Sexual Abuse Related to Poor Sleep Among Former Opioid-Addicted Women With and Without Methadone Maintenance Treatment?

ABSTRACT

To study whether poor sleep that is known to characterize methadone maintenance treatment (MMT) patients may be related to their past sexual abuse and/or their treatment modality, we compared perceived sleep indices (Pittsburgh Sleep Quality Index (PSQI); Epworth Sleepiness Scale (ESS)) and depression (21-HAM-D) between women with and without sexual abuse history (Childhood Trauma Questionnaire) in MMT and in a non-MMT ("opioid medication-free") in-patient rehabilitation center (MABAT). Twenty-six sexually abused women in MMT had the worst sleep quality scores (PSQI) (10.4 ± 4.2), followed by 15 sexually abused non-MMT women (7.9 ± 4.8), with the lowest score among 13 MMT non-sexually abused women (6.3 ± 4.8, p = 0.03). ESS score and cognitive state scores (Mini Mental State Exam) were similar. Depression (21-HAM-D) score was similar between the two sexually abused (MABAT and MMT) groups (15.3 ± 7.0 and 15.0 ± 6.3, respectively), but was significantly higher than the nonabused MMT group (10.5 ± 6.3, p = 0.03). Logistic regression model for being poor sleeper (PSQI >5), found depression OR = 1.2 (95% CI 1.1-1.4, p = 0.001), and poor cognitive state (MMSE) OR = 0.6 (95% CI 0.3-0.9, p = 0.03) to characterize poor sleep. We conclude that poor sleepers were depressed and this characterized sexually abused women in both the MMT and non-MMT groups.