Joint Trajectories of Insomnia Severity and Quality of Life Among Adults in Opioid Use Disorder Treatment: A...

Sleep health is related to quality of life (QOL) in the general population, yet less is known about the trajectories of sleep and QOL during opioid use disorder (OUD) treatment. This study examined the joint trajectories of insomnia severity and QOL during the first 4 weeks of OUD treatment and tested predictors of the growth trajectories. Adults (N = 1607) in supervised withdrawal or residential OUD treatment completed surveys weekly for 4 weeks. Kruskal-Wallis tests and correlations examined differences in insomnia and QOL at intake by sociodemographic and clinical characteristics. An unconditional parallel process growth model examined the joint trajectories of sleep and QOL, and time-invariant covariates were added to a conditional growth model. In the unconditional growth model, insomnia and QOL were inversely related at intake (p < 0.001). Greater insomnia at intake was associated with more pronounced increases in QOL (p = 0.020), but QOL at intake did not predict changes in insomnia. Increases in insomnia severity were associated with worsening of QOL (p < 0.001). Patients who were younger (p = 0.020) and unemployed (p = 0.048) had greater improvements in insomnia, and patients who were younger (p = 0.001) and started treatment in a supervised withdrawal setting (p = 0.002) had greater improvements in QOL. Sleep quality and QOL are modifiable, so understanding their joint trajectories during OUD treatment can help improve quality of care and recovery. Targeting sleep disturbances early in treatment may support overall well-being and improve recovery outcomes.