Evaluación de las alteraciones del sueño en pacientes drogodependientes hospitalizados

doi:10.1016/j.medcli.2011.07.015

Medicina Clínica

Volume 138, Issue 8, 7 April 2012, Pages 332-335

https://doi.org/10.1016/j.medcli.2011.07.015 Get rights and content

Resumen

Fundamento y objetivo

Estudiar los trastornos del sueño en pacientes drogodependientes ingresados, en función del tipo de consumo y la existencia de desintoxicaciones previas.

Pacientes y método

Se evaluaron 150 adictos ingresados en una unidad de desintoxicación hospitalaria mediante la entrevista SCID-I. Completaron un cuestionario autoaplicado de 11 ítems (tipo Likert de 1-mínimo a 7-máximo) que evaluó las alteraciones del sueño y su relación con el consumo.

Resultados

El 75,3% eran varones. La sustancia principal de ingreso fue en un 39% el alcohol, en el 34,67% cocaína, en el 30% politoxicómanos, en el 22,67% opiáceos, en el 18% benzodiacepinas y en el 14% cannabis. El 68,1% presentaron alteraciones del sueño y el 80,1% relacionaron sus problemas del sueño con la dependencia. Todos los pacientes con ingresos previos (47,3%) mostraban preocupación por presentar alteraciones del sueño durante el ingreso y referían mayor insomnio (43,7 frente a 22,8%, p < 0,05). Los politoxicómanos presentaban más alteraciones del sueño (57,8 frente a 24,3%, p < 0,05) que el resto. El insomnio fue referido principalmente por los alcohólicos (61%). El 86% utilizaron benzodiacepinas, el 75,4% sin prescripción.

Conclusiones

Las alteraciones del sueño en drogodependientes son muy frecuentes. Los pacientes con ingresos previos y los politoxicómanos son los que presentan más alteraciones del sueño.

Abstract

Background and objective

We aimed to study the relationship between sleep disorders and the type of substance use and the number of previous hospitalizations in patients admitted in a detoxification unit.

Patients and methods

We evaluated 150 drug-dependent inpatients with SCID-I. Patients were asked to complete an 11-item questionnaire measure (Likert scales from 1-minimum to 7-maximum) designed to assess the relationship between sleep disorders and drug use.

Results

75.3% were men. 39% were alcoholic, 34,67% cocaine-users, 30% poly-drug users, 22.6% opioid, 18% benzodiazepine and 14% cannabis-dependent patients. 68.1% reported experiencing sleep problems. 80.1% related sleep disorders to drug consumption. Worry about sleep problems was found in all patients with previous hospitalizations (47.3%). This group experienced more insomnia than those who had never been hospitalized (43.7 vs 22.8%, P < .05). Poly-drug users perceived more sleep disorders (57.8 vs 24.3%, P < .05). Insomnia was referred by 61% of alcoholic patients. 86% of the sample used benzodiazepines, 75.4% used them without prescription.

Conclusions

The perception of suffering from disordered sleep is frequent in drug addicts. Patients with poly-drug use and previous hospitalizations were the most affected.

Section snippets

Introducción

La relación entre las alteraciones del sueño y la adicción a drogas es bidireccional: los drogodependientes tienen una alta prevalencia de problemas de sueño¹ y las personas que presentan alteraciones del sueño tienen más riesgo de presentar problemas relacionados con el uso de sustancias que la población general2, 3.

Las alteraciones del sueño difieren según la droga consumida. El abuso de alcohol altera el patrón de sueño, disminuye la fase REM y dificulta el mantenimiento del sueño⁴. Los

Material y método

Estudio observacional, descriptivo y transversal en pacientes diagnosticados de trastorno por uso de sustancias según criterios DSM-IV-TR ingresados en la unidad de desintoxicación hospitalaria del Hospital Universitario Vall d’Hebron (enero 2005-marzo 2009).

Se excluyeron aquellos pacientes que pedían el alta voluntaria el primer día de ingreso, los que tenían dificultades para responder a las preguntas debido a alteraciones cognitivas o idiomáticas y los que colaboraron parcialmente al ser

Resultados

La muestra se componía de 150 pacientes (un 75,3% eran varones) diagnosticados de trastorno por dependencia de alcohol (39%), cocaína y otros estimulantes (36%), opiáceos (23%), benzodiacepinas (18%) y cannabis (14%). El 30% eran politoxicómanos. El 47,3% habían realizado desintoxicaciones hospitalarias previas una media (DE) de 1,03 (1,68) veces.

Se realizó un análisis dicotómico en valoración positiva/negativa (tabla 1). En el análisis cuantitativo se observó un alto grado de alteración

Discusión

La mayoría de pacientes (68,1%) refieren trastornos del sueño, tanto insomnio (64,7%) como hipersomnia (61%). Se observó un alto grado de alteración subjetiva del sueño. La posibilidad de presentar insomnio durante la desintoxicación preocupaba al 69,4% de la muestra. Uno de los datos más relevantes es que la gran mayoría de pacientes (80%) relacionaron sus trastornos del sueño con la adicción, por lo que resulta aconsejable evaluar el sueño rutinariamente en adictos.

Los pacientes más graves

Conflicto de intereses

Los autores declaran no tener ningún conflicto de intereses.

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Original breveEvaluación de las alteraciones del sueño en pacientes drogodependientes hospitalizadosEvaluation of sleep disorders in drug dependent inpatients

Resumen

Fundamento y objetivo

Pacientes y método

Resultados

Conclusiones

Abstract

Background and objective

Patients and methods

Results

Conclusions

Section snippets

Introducción

Material y método

Resultados

Discusión

Conflicto de intereses

Sleep Med

Polysomnographic sleep dysregulation in cocaine dependence

ScientificWorldJournal

Trastornos del sueño y consumo de hipnóticos en la isla de Mallorca

Rev Clin Esp

Sleep disturbance in heavy marijuana users

Sleep

Association between nocturnal vagal tone and sleep depth, sleep quality, and fatigue in alcohol dependence

Psychosom Med

Original breve
Evaluación de las alteraciones del sueño en pacientes drogodependientes hospitalizadosEvaluation of sleep disorders in drug dependent inpatients