3/18/2023 0 Comments Deepsleep narcoticsNumerous studies examining total sleep time from 2 to 4 weeks of abstinence document reduced sleep time compared to healthy controls (Table 2). Ĭongruent with increased sleep latency, total sleep time is reduced in persons with alcohol use disorders during periods of drinking, acute withdrawal, and post-acute withdrawal, with very few exceptions. After the second month of abstinence, sleep latency may still be increased, or normalized, with evidence for normalization also present after five and 9 months of abstinence. Published studies show that SL is prolonged during periods of drinking, during acute withdrawal (e.g., weeks 1 and 2 of abstinence), and during post-acute withdrawal (e.g., weeks 2 through 8), (Table 2) with evidence for sleep latency prolongation in inpatient and outpatient settings (e.g., ), and when controlled for age and sex, among other variables. Sleep latency (SL)Īlthough it is known that alcohol can decrease sleep latency when consumed by healthy persons, chronic use leads to increased sleep latency, consistent with individual self-report. Objective measurement of sleep in persons with alcohol use disorders confirms self-reported sleep problems in many respects, and provides additional insight into the nature of the underlying sleep abnormalities. Notably, sleep complaints associated with alcohol use disorders are one of the most refractory problems to resolve, and insomnia is the most frequent complaint among alcoholics after they stop drinking. Complaints typically include difficulty falling asleep, frequent awakenings, daytime sleepiness, and abnormal sleep quality, but could also include hypersomnia. These rates are substantially higher than those observed in the general population (i.e. ~15 to 30 %). Significant, self-reported sleep problems are highly prevalent among alcohol users with rates of clinical insomnia between approximately 35 and 70 % depending on the setting and stage of use, among other parameters. However, as the consumption of alcohol becomes chronic, alcohol has less of an hypnotic effect. For each drug, the available literature on subjective measurements, objective measurements, the relationship between subjective and objective measurements, clinical and laboratory correlates of sleep outcomes, and pharmacotherapies related to sleep were summarized.Īlcohol is widely used as a sleep-promoting agent. In addition to extracting data available in each of the retrieved articles, reference lists from each retrieved article were examined to identify articles missed by the initial search. For each drug (e.g., alcohol, cannabis/marijuana, cocaine, and opioids/heroin) keywords included terms describing abnormal/pathological use (e.g., alcohol use disorders, alcohol abuse, alcohol dependence, and alcohol addiction, etc.) combined with terms referring to sleep or sleep abnormalities. For the literature search, Pubmed, Ovid Medline, and Web of Science databases were used. This is a narrative, non-systematic review of clinical trials conducted in humans. Psychotherapy options, albeit evidence-based and of clear clinical value, will not be discussed in this review as these are addressed elsewhere. This paper will also review potential pharmacological agents that modulate sleep. In addition, this review will discuss evidence that sleep abnormalities predict use and relapse, and that sleep abnormalities can be modulated to improve clinical outcome. This review will describe such research with regard to alcohol, cannabis, cocaine, and opioids. Understanding the sleep problems related to substance use disorders requires characterizing them both subjectively and objectively, while considering how sleep responds to periods of use and abstinence. By improving our understanding of sleep disorders that either predispose to substance use or are the result of chronic substance use, we may be better able to prevent and treat substance use disorders. This paper aims to explore and clarify the strong yet not entirely understood connection between abnormalities in sleep and substance use. Evidence also indicates that long-term abstinence from chronic substance use can reverse some sleep problems. The association between substance use and sleep problems appears to be bidirectional, with sleep problems increasing risk for developing substance use disorders, and acute and chronic substance use leading to acute and chronic problems with sleep. Nearly 70 % of patients admitted for detoxification report sleep problems prior to admission, and 80 % of those who report sleep problems relate them to their substance use. Sleep problems are commonly associated with drug and alcohol use.
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