Abstract
Objective: Opioid addiction is a chronic, relapsing and psychosocial disorder. In opioid addiction patients, studies show that sleep disorders, deteriorated quality of sleep and sleep architecture changes might be seen. In addition, comorbid psychiatric disorder and depression are frequently seen in opioid addicts. Comorbid psychiatric disorders and symptoms worsen of sleep quality in opioid addicts. This study aims to evaluate the quality of sleep during the periods of pre-treatment and in early opioid agonist maintenance treatment in the opioid addicts. Methods: The research included 29 patients in the Alcohol and Substance Addiction Treatment Unit of Trakya University Faculty of Medicine who have met diagnostic criteria for opioid addiction according to DSM-5, completed 28-day treatment, and admitted for control to Alcohol and Substance Addiction Treatment Unit after 1 month from discharge. The Hamilton Depression Rating Scale, Hamilton Anxiety Rating Scale, Pittsburgh Sleep Quality Index are administered to all the patients who participated to the study on the day 1, day 28, and in the month 2. All the patients were treated with buprenorphine and naloxone combination. Results: In our study, a time-dependent significant de-crease from day 1 to month 2 was determined in the average scores of the Pittsburgh Sleep Quality Index, which evaluates the sleep quality. In addition, the Pittsburgh Sleep Quality Index average scores showed differences in all time periods. Our study also determined a time-dependent significant decrease in the average scores of the Hamilton Depression Rating Scale and the Hamilton Anxiety Rating Scale, which evaluates respectively the depressive symptoms and anxiety symptoms on the day 0, day 28 and day 60. Discussion: In our research, we evaluated the sleep quality and the symptoms of depression and anxiety of the patients diagnosed with opioid addiction in pre-treatment and early period of opioid agonist maintenance treatment, and showed that those symptoms were getting better with treatment. We think that these findings can guide further research, as they show that opioid treat-ment does not only serve for addiction treatment but also for the treatment of the symptoms accompanying the opioid addiction.

Key words: Opioid addiction, sleep, depression, anxiety, buprenorphine, naloxone

---

Buprenorfin/nalokson tedavisi gören opiyat baðýmlýsý hastalarda tedavinin erken döneminde uyku kalitesinin deðerlendirilmesi

Ozet
Amaç: Opiyat baðýmlýlýðý kronik, yineleyici ve biyopsikososyal bir bozukluktur. Opiyat baðýmlýlarýnda uyku bozukluk-larý, uyku kalitesinde bozulma ve uyku yapýsýnda farklýlýklar görülebilmektedir. Buna ek olarak opiyat baðýmlýlarýnda depresyon ve diðer psikiyatrik bozukluk eþ tanýsý sýk görülmektedir. Psikiyatrik belirtiler ve eþ taný bu hastalarda uyku kalitesini bozmaktadýr. Bu çalýþmada opiyat baðýmlýlýðý olan hastalarda tedavi öncesi, opiyattan arýndýrma ve opiyat parsiyel agonist idame tedavisi süresince uyku kalitelerinin deðerlendirilmesi amaçlanmýþtýr. Yöntem: Araþ-týrmaya DSM-5 ölçütlerine göre opiyat kullaným bozukluðu taný ölçütlerini karþýlayan, 28 günlük tedavi programýný tamamlayan ve taburculuk sonrasý birinci ayda AMATEM polikliniðine izleme kontrolüne gelen 29 hasta alýnmýþtýr. Araþtýrma katýlan tüm hastalara 1. gün, 28. gün ve 2. ayda Hamilton Depresyon Derecelendirme Ölçeði, Hamilton Anksiyete Deðerlendirme Ölçeði, Pittsburgh Uyku Kalitesi Ölçeði uygulanmýþtýr. Hastalarýn hepsi buprenorfin/nalok-son kombinasyonu ile tedavi edilmiþlerdir. Sonuçlar: Araþtýrmamýzda 1. gün, 28. gün ve 2. ayda uyku kalitelerinin anlamlý olarak düzeldiði ve uykusuzluðun azaldýðý; ayrýca 1. gün, 28. gün ve 2. ayda depresif ve anksiyete belirtile-rinde zamana göre anlamlý bir düþüþ olduðu bulunmuþtur. Tartýþma: Araþtýrmamýzda opiyat baðýmlýlýðý hastala-rýnda uyku kalitesi, depresif ve anksiyete belirtilerinin tedavi öncesi ve opiyat parsiyel agonist tedavisinin erken dönemi süresince düzelme gösterdiði saptanmýþtýr. Bu bulgular opiyat baðýmlýlarýnda baðýmlýlýk ile beraber, uyku-suzluk gibi eþlik eden ruhsal belirtilerin de tedavi ile düzeldiðini göstermiþtir.

Anahtar Kelimeler: Opiyat baðýmlýlýðý, uyku, depresyon, anksiyete, buprenorfin, nalokson