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

项目总结 睡眠不足，包括睡眠不足、一天中错误的睡眠时间或睡眠质量差， 可能会影响最近出狱人员的OUD治疗参与度和保留率。沉睡 缺乏可能导致生物、精神和药理学机制，如应激、负面影响、 疼痛或其他物质使用可能增加非法使用阿片类药物的可能性，并在OUD中脱离接触 治疗。此外，释放监禁可能会增加睡眠不足的程度。被监禁的人比 可能目睹并直接经历创伤，而创伤反过来又会导致噩梦，从而影响睡眠健康， 失眠、睡眠呼吸暂停和睡眠障碍。从监禁中释放可能会导致重大的 睡眠习惯的中断。在监狱里，人们经常睡在灯光，噪音， 和时间表都不在他们的控制范围之内，或者他们在哪里用药睡觉。来自该环境的变化 可能会造成睡眠困难。我们的长期目标是减少以下疾病的发病率和死亡率 涉及正义的个人。本附录的总体研究目标是考察这种联系。 接受OUD药物治疗的患者样本中睡眠不足与OUD治疗保留之间的关系 (穆德)，他们最近从监狱获释。这项建议汇集了两家医疗基金资助的公司的专长 耶鲁大学医学院助学金，[5UG1DA050072-02-JCOIN，过渡诊所网络：监禁后 成瘾治疗、医疗保健和社会支持(TCN路径)和1U01HL150596-01-云 研究]，这两个目的都是为了了解和改善Moud的参与和保持。中心假说 这一补充的结论是，睡眠不足与较差的OUD治疗保持能力有关，而睡眠 环境是这种联系的一个新的中介因素。这项研究的基本原理是睡眠 必须以整体的方式解决不足，以支持我们的治疗参与。我们的目标是：(1) 确定睡眠不足的流行率，并描述样本人群的睡眠环境 Moud最近出狱；(2)评估睡眠不足和OUD治疗之间的联系 检查睡眠环境作为睡眠不足和OUD治疗的潜在中介因素 最近从监狱释放的人的滞留。为了实现这些目标，来自两个TCN路径站点的参与者 (n=220)将完成匹兹堡睡眠质量指数(PSQI)并在手腕上佩戴设备(Actiwatch) 这将记录参与者的睡眠环境和睡眠期间环境光的数据。此外，我们还将 使用来自国家交通噪音地图和中心的邻居级噪音和灯光数据 疾病控制与预防描述参与者的睡眠环境。我们将测量我们的治疗 在松解后1、3和6个月保持固位。这项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，从而提高 他们在治疗中的滞留。

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.