AUTHOR=Manzar Md Dilshad , Alghadir Ahmad H. , Khan Masood , Salahuddin Mohammed , Hassen Hamid Yimam , Almansour Ahmed M. , Nureye Dejen , Tekalign Eyob , Shah Showkat Ahmad , Pandi-Perumal Seithikurippu R. , Bahammam Ahmed S. TITLE=Poor Sleep in Community-Dwelling Polysubstance Users: Association With Khat Dependence, Metacognition, and Socio-Demographic Factors JOURNAL=Frontiers in Psychiatry VOLUME=Volume 13 - 2022 YEAR=2022 URL=https://www.frontiersin.org/journals/psychiatry/articles/10.3389/fpsyt.2022.792460 DOI=10.3389/fpsyt.2022.792460 ISSN=1664-0640 ABSTRACT=Purpose: Sleep disturbances and cognitive deficits are often associated with increased drug use. However, no study has addressed the relationship between sleep quality, substance dependence, and metacognitive deficit in polysubstance users. Methods: This was a cross-sectional study with a simple random sampling involving community-dwelling polysubstance users (n=326, age=18-43 years) in Mizan, Ethiopia. Participants completed a brief sleep questionnaire, severity of dependence on Khat (SDS-Khat), a brief meta-cognition questionnaire, and a Socio-demographic survey. Results: Majority (56.4%) of the polysubstance users had sleep disturbance. Chronic health conditions (AOR) = 2.52, 95% (CI)1.31-4.85), chronic conditions in the family (AOR) = 2.69, 95%(CI)1.40-5.20), Illiterate-primary level of educational status (AOR) = 2.40, 95%(CI)1.30-4.04), higher SDS-Khat score (AOR) = 1.39, 95%(CI)1.13-1.72), and lower meta-cognition score (AOR) = 0.90, 95%(CI)0.84-0.97) predicted poor sleep in the polysubstance users. Moreover, low metacognition score and high SDS score also predicted additional sleep disturbances like chronic sleep insufficiency, lethargy and restlessness after nighttime sleep, socio-occupational dysfunctions, and daytime disturbances in polysubstance users. Conclusion: Poor sleep, severe khat-dependence, metacognitive deficits are common in community polysubstance users. Moreover, poor sleep is associated with higher khat-dependence, lower metacognitive ability, lower educational status, and the presence of chronic conditions in polysubstance users or their families.