# Transitions Clinic Network:  Post Incarceration Addiction Treatment, Healthcare, and Social Support (TCN PATHS) study

> **NIH NIH UG1** · YALE UNIVERSITY · 2020 · $398,221

## Abstract

PROJECT SUMMARY
Sleep deficiency, which includes sleep deprivation, sleeping at the wrong time of day, or poor quality of sleep,
may affect OUD treatment engagement and retention among people recently released from jail. Sleep
deficiency may lead to biologic, psychiatric, and pharmacologic mechanisms, such as stress, negative affect,
pain or other substance use that may increase the likelihood of illicit opioid use, and disengagement in OUD
treatment. Further, release from incarceration may increase sleep deficiency. Incarcerated people are more
likely to witness and directly experience trauma which can, in turn, affect sleep health by causing nightmares,
insomnia, sleep apnea, and general sleep disruption. Release from incarceration can cause significant
disruptions in sleep habits. In jails, people are often subjected to sleeping in environments where lights, noise,
and schedule are out of their control or where they are medicated to sleep. Changes from that environment
may create difficulties with sleep. Our long-term goal is to reduce morbidity and mortality from OUD among
justice-involved individuals. The overall research objective of this supplement is to examine the association
between sleep deficiency and OUD treatment retention in a sample of people receiving medications for OUD
(MOUD) who were recently released from jail. This proposal brings together the expertise of two HEAL-funded
grants at Yale School of Medicine, [5UG1DA050072-02-JCOIN, Transitions Clinic Network: Post Incarceration
Addiction Treatment, Healthcare, and Social Support (TCN PATHS) and 1U01HL150596-01- The CLOUDS
Study], both aimed at understanding and improving MOUD engagement and retention. The central hypothesis
of this supplement is that sleep deficiency is associated with worse OUD treatment retention and that sleep
environment is a novel mediator of this association. The underlying rationale for this study is that sleep
deficiency must be addressed in a holistic manner to support OUD treatment engagement. We aim to: (1)
Determine the prevalence of sleep deficiency and describe the sleep environment of a sample of people on
MOUD recently released from jail; (2) Estimate the association between sleep deficiency and OUD treatment
retention; and (3) Examine sleep environment as a potential mediator of sleep deficiency and OUD treatment
retention in people recently released from jail. To achieve these aims, participants from two TCN PATHS sites
(n=220) will complete the Pittsburg Sleep Quality Index (PSQI) and wear a device on their wrist (Actiwatch)
that will record data on the participant’s sleep environment and ambient light during sleep. Additionally, we will
use neighborhood-level noise and light data from the National Transportation Noise Map and the Centers for
Disease Control and Prevention to describe participants’ sleep environment. We will measure OUD treatment
retention at 1,3, and 6-months post release. This study will provide data for the future develop...

## Key facts

- **NIH application ID:** 10177211
- **Project number:** 3UG1DA050072-02S2
- **Recipient organization:** YALE UNIVERSITY
- **Principal Investigator:** Emily Ai-hua Wang
- **Activity code:** UG1 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $398,221
- **Award type:** 3
- **Project period:** 2019-07-15 → 2024-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10177211

## Citation

> US National Institutes of Health, RePORTER application 10177211, Transitions Clinic Network:  Post Incarceration Addiction Treatment, Healthcare, and Social Support (TCN PATHS) study (3UG1DA050072-02S2). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10177211. Licensed CC0.

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