Transitions Clinic Network: Post Incarceration Addiction Treatment, Healthcare, and Social Support (TCN PATHS) study

项目摘要 睡眠不足，包括睡眠不足，在一天中的错误时间睡觉，或睡眠质量差， 可能会影响最近从监狱释放的人对OUD治疗的参与和保留。睡眠 缺乏可能导致生物学、精神病学和药理学机制，如压力，负面影响， 疼痛或其他物质的使用可能会增加非法阿片类药物使用的可能性，以及OUD的脱离 治疗此外，从监禁中释放可能会增加睡眠不足。被监禁的人 可能目睹并直接经历创伤，这反过来会通过引起噩梦影响睡眠健康， 失眠、睡眠呼吸暂停和一般睡眠中断。从监禁中释放可能会导致严重的 睡眠习惯的破坏。在监狱里，人们经常要睡在灯光，噪音， 和时间表是他们无法控制的，或者他们在哪里被药物治疗睡觉。环境的变化 可能会造成睡眠困难。我们的长期目标是降低OUD的发病率和死亡率， 正义相关的人。本增刊的总体研究目标是研究 在接受OUD药物治疗的人群样本中， 最近刚从监狱释放的人。这项提案汇集了两个卫生保健资助的专业知识， 耶鲁医学院的赠款，[5 UG 1DA 050072 -02-JCOIN，过渡诊所网络：监禁后 成瘾治疗，医疗保健和社会支持（TCN PATHS）和1U 01 HL 150596 -01-云 研究]，两者都旨在了解和改善MOUD的参与和保留。核心假设 睡眠不足与更差的OUD治疗保持有关， 环境是这种关联的一个新的中介。这项研究的基本原理是， 必须以全面的方式解决不足之处，以支持OUD治疗参与。我们的目标是：（1） 确定睡眠不足的患病率，并描述一个样本的人的睡眠环境， MOUD最近从监狱释放;（2）估计睡眠不足和OUD治疗之间的关联 保持;和（3）检查睡眠环境作为睡眠不足和OUD治疗的潜在介质 最近从监狱释放出来的人。为了实现这些目标，来自两个TCN PATHS站点的参与者 （n=220）将完成伯格睡眠质量指数（PSQI），并在手腕上佩戴设备（Actiwatch） 它将记录参与者睡眠环境和睡眠期间环境光线的数据。此外，我们将 使用来自国家交通噪音地图和交通噪音中心的社区级噪音和灯光数据。 疾病控制和预防描述参与者的睡眠环境。我们将测量OUD治疗 释放后1个月、3个月和6个月的保留率。本研究将为今后的开发和测试提供数据 以患者为中心的干预措施，重点关注OUD治疗参与者的睡眠不足， 在治疗中的保留。

PROJECT SUMMARY Sleep deficiency, which includes sleep deprivation, sleeping at the wrong time of day, or poor quality of sleep, may affect OUD treatment engagement and retention among people recently released from jail. Sleep deficiency may lead to biologic, psychiatric, and pharmacologic mechanisms, such as stress, negative affect, pain or other substance use that may increase the likelihood of illicit opioid use, and disengagement in OUD treatment. Further, release from incarceration may increase sleep deficiency. Incarcerated people are more likely to witness and directly experience trauma which can, in turn, affect sleep health by causing nightmares, insomnia, sleep apnea, and general sleep disruption. Release from incarceration can cause significant disruptions in sleep habits. In jails, people are often subjected to sleeping in environments where lights, noise, and schedule are out of their control or where they are medicated to sleep. Changes from that environment may create difficulties with sleep. Our long-term goal is to reduce morbidity and mortality from OUD among justice-involved individuals. The overall research objective of this supplement is to examine the association between sleep deficiency and OUD treatment retention in a sample of people receiving medications for OUD (MOUD) who were recently released from jail. This proposal brings together the expertise of two HEAL-funded grants at Yale School of Medicine, [5UG1DA050072-02-JCOIN, Transitions Clinic Network: Post Incarceration Addiction Treatment, Healthcare, and Social Support (TCN PATHS) and 1U01HL150596-01- The CLOUDS Study], both aimed at understanding and improving MOUD engagement and retention. The central hypothesis of this supplement is that sleep deficiency is associated with worse OUD treatment retention and that sleep environment is a novel mediator of this association. The underlying rationale for this study is that sleep deficiency must be addressed in a holistic manner to support OUD treatment engagement. We aim to: (1) Determine the prevalence of sleep deficiency and describe the sleep environment of a sample of people on MOUD recently released from jail; (2) Estimate the association between sleep deficiency and OUD treatment retention; and (3) Examine sleep environment as a potential mediator of sleep deficiency and OUD treatment retention in people recently released from jail. To achieve these aims, participants from two TCN PATHS sites (n=220) will complete the Pittsburg Sleep Quality Index (PSQI) and wear a device on their wrist (Actiwatch) that will record data on the participant’s sleep environment and ambient light during sleep. Additionally, we will use neighborhood-level noise and light data from the National Transportation Noise Map and the Centers for Disease Control and Prevention to describe participants’ sleep environment. We will measure OUD treatment retention at 1,3, and 6-months post release. This study will provide data for the future development and testing of patient-centered interventions focusing on sleep deficiency among OUD treatment participants that enhance their retention in treatment.