L’exploration des liens entre le soutien social et la qualité de sommeil chez les consommateurs âgés de benzodiazépines

Abstract Several older benzodiazepine (BZD) users are affected by severe sleep problems. Various factors may be associated with these sleeping difficulties, such as old age, side effects of medication or presence of anxiety or depression. Although social support is another variable that could contribute to quality of sleep in this population, research has yet to address this issue. The objective of this study was to explore how social support is associated with quality of sleep in older BZD users. More specifically, we aimed to: 1) verify if there is a link between overall quality of sleep and the quantity of people on which a person can rely in case of need (first dimension of social support, related to ‘availability’); 2) investigate if there is an association between overall quality of sleep and satisfaction related to the perceived availability of social support (second dimension of social support), and 3) explore relations between these two dimensions of social support and specific subdimensions of sleep (e.g. presence of sleep disorders, sleep onset latency). To this end, we used data from the pretest (T1) of the ‘Programme d’Aide de Succès à un Sevrage (PASSE-60+)’ study which was initiated in January 2015 at the Institut universitaire de gériatrie de Montréal (CRIUGM). In total, this study included 66 participants aged between 60 and 85 years old who wanted to taper or stop their use of BZD. Quality of sleep was measured with the Pittsburgh Sleep Quality Index (PSQI), while social support was assessed with the Social Support Questionnaire (SSQ-6), since it addressed the two dimensions of social support that were targeted in the present study (availability and satisfaction related to social support). Spearman correlations were used to investigate associations between aforementioned iv variables. Additional curve-estimation analyses were carried out to explore nonlinear associations between variables related to social support and dimensions of sleep. All hypotheses were tested with an alpha significance level of 0.05. Our analyses demonstrated the following points: 1) Overall sleep quality showed a quadratic association with satisfaction stemming from social support; 2) the less individuals appeared satisfied with their social support, the more they showed diurnal dysfunctions related to poor sleep quality; 3) overall quality of sleep was not significantly associated with the availability of support. Our results thus suggest that sleep quality in older BZD users is more closely associated with satisfaction due to the support received than with the number of people available for assistance. Since tapering of this medication is distressing for dependent users, as they experience various withdrawal symptoms and rebound insomnia or anxiety, social support becomes all the more valuable during this difficult experience. Results of the present study may prove useful for the adjustment of therapeutic interventions aiming to support tapering. As a matter of fact, it would be relevant to take into account satisfaction related to social support in therapy sessions in order to facilitate successful BZD tapering in older people with severe sleep problems. Keywords: older people, benzodiazepines, sleeping pills, social support, quality of sleep, mental health.

Keyphrases: older people, benzodiazepines, sleeping pills, social support, quality of sleep, mental health