• Avaion Ruth, Siddhi S Ganesh, Pooja Shah, Erin E Gould, Katrina Ninh, Rachel Carmen Ceasar, Dustin T Duncan, and Ricky N Bluthenthal.
• Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
• J Urban Health. 2024 Oct 1; 101 (5): 105810671058-1067.

AbstractChronic insufficient and poor-quality sleep are linked to hypertension, diabetes, depression, heart attack, and stroke. While studies on substance use and sleep typically focus on people in or entering treatment, there is a lack of research on sleep health among community-recruited people who inject drugs (PWID). To address this literature gap, we examined factors associated with insufficient and poor-quality sleep among community-recruited PWID. We recruited and interviewed 472 active opioid-using PWID (injected within the last 30 days) in Los Angeles, CA and Denver, CO between 2021 and 2022. Participants completed computer-assisted interviews covering demographics, subsistence measures, drug use patterns, injection-related behaviors, health risks, and sleep duration and quality in the last 3 months. Descriptive statistics were used to analyze all variables for subjects with complete responses to sleep items (n = 464). Bivariate analyses determined factors associated with sleep measures using chi-square and t-tests. Collinear variables were removed, and binomial linear multivariable regression calculated risk ratios (RR) for insufficient and poor-quality sleep in the last 3 months. Participants exhibited low sleep duration (mean = 4.99, standard deviation (SD) = 2.70), with 76% reporting insufficient sleep and 62% poor-quality sleep. Bivariate analyses associated both sleep measures with drug use, high subsistence scores, violent victimization, and poor health outcomes. Multivariable analyses showed a high subsistence score predicting insufficient (RR = 1.31) and poor-quality sleep (RR = 1.69) compared to low subsistence. Poor sleep health is common among structurally vulnerable community-recruited PWID, as measured by subsistence index associated with adverse sleep outcomes. Further research on structural interventions to address sleep and subsequent health outcomes among PWID is imperative.© 2024. The Author(s).

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