Relationship of chronotype, biological rhythm characteristics and sleep quality with suicidal behavior in patients with opioid use disorder

Abstract

Opioid Use Disorder (OUD) carries a high risk of psychiatric comorbidities, such as depression, sleep disturbances and suicidal behaviour. Recent findings emphasise the impact of chronotype and biological rhythm disturbances on the severity of addiction and suicidality. This study examined the associations between chronotype, biological rhythm characteristics, sleep quality, depressive symptoms and suicidal behaviour in individuals with OUD. A total of 159 patients diagnosed with OUD and 154 healthy controls were evaluated using validated scales, including the Columbia Suicide Severity Rating Scale, Biological Rhythm Assessment Interview, Morningness-Eveningness Questionnaire, Pittsburgh Sleep Quality Index, Beck Depression Inventory and Addiction Profile Index. The results showed that individuals with OUD had significantly higher rates of suicidal ideation and attempts, poorer sleep quality, more irregular biological rhythms and more severe depressive symptoms than the control group. An evening chronotype was more prevalent in the OUD group and was associated with greater addiction severity, disrupted rhythms, poor sleep quality, and increased suicidality. Higher depression severity was significantly associated with lower morningness preferences, and sleep quality was found to explain a significant portion of the shared variance between depressive symptoms and suicidal outcomes. These findings suggest that assessing chronotype and circadian dysregulation could help to identify high-risk patients and inform the development of targeted interventions to improve outcomes in OUD treatment.