Evidence map›Paper›PMID 37980246›Full record

ArticleSleep health2024

"It's all connected:" A mixed methods study of insomnia, stigma, and discrimination among individuals on medication for opioid use disorder.

Uzoji Nwanaji-Enwerem, Lois S Sadler, Meghan O'Connell, Declan Barry, Tish M Knobf, Sangchoon Jeon, Dustin Scheinost, Klar Yaggi, Nancy S Redeker

Abstract read
In one paragraph

Article in Sleep health, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Uzoji Nwanaji-EnweremYale School of Nursing, Orange, Connecticut, USA; Yale School of Public Health, New Haven, Connecticut, USA. Electronic address: Uzoji.nwanaji-enwerem@yale.edu.
Lois S SadlerYale School of Nursing, Orange, Connecticut, USA; Yale School of Public Health, New Haven, Connecticut, USA.
Meghan O'ConnellUCONN School of Nursing, Storrs, Connecticut, USA; Yale School of Public Health, New Haven, Connecticut, USA.
Declan BarryAPT Foundation, New Haven, Connecticut, USA; Yale School of Medicine, New Haven, Connecticut, USA; Yale School of Public Health, New Haven, Connecticut, USA.
Tish M KnobfYale School of Nursing, Orange, Connecticut, USA; Yale School of Public Health, New Haven, Connecticut, USA.
Sangchoon JeonYale School of Nursing, Orange, Connecticut, USA; Yale School of Public Health, New Haven, Connecticut, USA.
Dustin ScheinostYale School of Medicine, New Haven, Connecticut, USA; Yale School of Public Health, New Haven, Connecticut, USA.
Klar YaggiYale School of Medicine, New Haven, Connecticut, USA; Yale School of Public Health, New Haven, Connecticut, USA.
Nancy S RedekerUCONN School of Nursing, Storrs, Connecticut, USA; Yale School of Public Health, New Haven, Connecticut, USA.

Funding

The Collaboration Linking Opioid Use Disorder and Sleep ("CLOUDS") StudyU01HL150596 · NHLBI · YALE UNIVERSITY · PI BARRY, DECLAN T., REDEKER, NANCY S · 2019 to 2024
$5.1M
A Mixed Methods Exploration of Stigma, Discrimination, and Sleep Among Those on Medication for Opioid Use DisorderF31DA054762 · NIDA · YALE UNIVERSITY · PI NWANAJI-ENWEREM, UZOJI · 2022 to 2023
$70k
NHLBI NIH HHS U01 HL150596NIDA NIH HHS F31 DA054762
6 · The paper itself

Abstract

objectivesInsomnia is one of the most common sleep disorders among those with opioid use disorder (OUD), including those on medication for OUD. There is a dearth of literature exploring the role of social stressors on sleep outcomes among this group. The purpose of this study was to explore the association between OUD-related stigma and intersectional discrimination with insomnia among individuals on medication for OUD.

methodsParticipants were recruited from treatment clinics in the Northeast United States. Using a convergent mixed-methods research design, we explored associations with stigma (The Brief Opioid Stigma Scale), intersectional discrimination (Intersectional Discrimination Index), and insomnia (Insomnia Severity Index) through quantitative survey data and qualitative data from interviews for participant experiences. Data from the quantitative (n = 120) and qualitative (n = 25) components of the study were integrated for interpretation.

resultsQuantitative analysis indicated weak to moderate positive correlations between intersectional discrimination, and exploratory variables including pain, perceived stress, and psychological distress with insomnia severity. The qualitative analysis generated 4 main themes, which highlighted negative emotions and ruminations as factors that participants connected experiences with stigma and discrimination to poor sleep outcomes. Integration of data identified concordant and discordant findings.

conclusionsStigma, discrimination, physical symptoms, and psychological distress appear to contribute to poor sleep outcomes among those with OUD. Future research should target maladaptive outcomes of rumination and negative emotions to improve sleep outcomes among those with OUD.

Indexed as

Opioid-Related DisordersSleep Initiation and Maintenance DisordersAnalgesics, OpioidHumansPainSocial StigmaAnalgesics, OpioidDiscriminationInsomniaIntersectionalityMixed methodsStigmaSubstance use disorders

Identifiers

PMID37980246
PMCPMC12964356

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.