The relationship between impulsivity, craving, sleep disorder and night eating syndrome in remitted patients with opioid use disorder

Objective: In our study, it was aimed to compare opiate use disorder patients in remission with healthy volunteers in terms of sleep disorder, night eating syndrome and impulsivity; and also to determine the relationships between these variables and craving. Method: This research was conducted at Akdeniz University Alcohol and Substance Addiction Research and Application Center (AMBAUM) and is a descriptive and cross-sectional study. A total of 100 outpatients, aged 18-65 years, who were diagnosed with opiate use disorder according to DSM-5 diagnostic criteria, who were in remission for at least 1 month with buprenorphine/naloxone treatment, were included in the study. As the control group, 100 healthy volunteers with similar characteristics in terms of age and gender with the patient group and without a history of substance use were recruited. Pittsburgh Sleep Quality Index, Night Eating Questionnaire, Barratt Impulsivity Scale-11 were administered to all participants, along with a semi-structured Sociodemographic Data Form developed by the researchers in the form of face-to-face questions and answers. In addition, The Substance Craving Scale was given to the patients. Results: In our study, we found that the Night Eating Questionnaire total score (p<0.001), Night Eating (p<0.001), Evening Hyperphagia (p=0.022) and Mood Disorder (p=0.049) sub-dimension scores were found in the patient group. Pittsburgh Sleep Quality Index(PUKI) scores of the patient group were also found to be statistically significantly higher (p<0.001). Barrat Impulsivity Scale (BIS-11) total score (p=0.009) and attention impulsivity (p=0.021) and not planning (p=0.004) sub-dimension scores were found to be statistically higher in the patient group compared to the control group. When the relationship between the scales was examined in the patient group, it was determined that there was a positive bidirectional correlation with the risk of night eating syndrome and poor sleep quality. PUKI scores were higher in the group with night eating syndrome risk (p<0.001), and patients with poor sleep quality were found to be more common in this group (risky: 88.5% and no risk: 59.5%; p=0.007). The risk of night eating disorder was also higher in patients with poor sleep quality (34.3% vs. 9.1%; p=0.007). Patients with sleep disorders had higher Substance Craving scale scores (p<0.001). The mean BIS-11 scale score was higher in both patients with poor sleep quality (p<0.001) and patients at risk of night eating syndrome (p=0.010).Substance Craving scale scores were statistically higher in patients with poor sleep quality (p<0.001). There was no significant relationship between being at risk for night eating disorder and substance craving (p=0.069). As a result of the regression analysis, it was determined that poor sleep quality (β=0.200, p=0.039) and increased BIS-11 scores (β=0.345, p<0.001) were positively and independently associated with craving scores. It was determined that poor sleep quality and impulsivity were factors that independently predicted substance craving. Discussion: As a result of our study, it can be said that opiate use disorder patients in remission have worse sleep quality, more night eating syndrome and more impulsivity than healthy controls. However, it can be said that poor sleep quality and impulsivity directly predict craving. Keywords: Opioid use disorder, craving, impulsivity, night eating syndrome, sleep disorder