Journal
EXPERIMENTAL AND CLINICAL PSYCHOPHARMACOLOGY
Volume 30, Issue 6, Pages 1024-1035Publisher
AMER PSYCHOLOGICAL ASSOC
DOI: 10.1037/pha0000477
Keywords
opioid use disorder; sleep; sleep disturbance; treatment; circadian
Funding
- National Center for Complementary and Integrative Health [R61 AT010134 02]
- National Institute on Drug Abuse [R01 DA048206 02]
- National Heart, Lung and Blood Institute [U01 HL150835 01]
- Ashley Addiction Treatment
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The importance of addressing sleep disturbances in individuals with opioid use disorder is highlighted in this narrative review. Sleep issues are commonly reported among this population and are associated with negative treatment outcomes. More research and clinical trials are needed to explore the potential benefits of targeting sleep to improve OUD treatment.
Public Significance Statement In light of the ongoing opioid crisis, there is a pressing need to improve treatment outcomes for opioid use disorder. Sleep disturbance is a common complaint among persons with opioid use disorder, and interventions that target sleep in this population could improve stress, affect, craving, and/or relapse outcomes. Sleep health is an important factor across several physical and mental health disorders, and a growing scientific consensus has identified sleep as a critical component of opioid use disorder (OUD), both in the active disease state and during OUD recovery. The goal of this narrative review is to collate the literature on sleep, opioid use, and OUD as a means of identifying therapeutic targets to improve OUD treatment outcomes. Sleep disturbance is common and often severe in persons with OUD, especially during opioid withdrawal, but also in persons on opioid maintenance therapies. There is ample evidence that sleep disturbances including reduced total sleep time, disrupted sleep continuity, and poor sleep quality often accompany negative OUD treatment outcomes. Sleep disturbances are bidirectionally associated with several other factors related to negative treatment outcomes, including chronic stress, stress reactivity, low positive affect, high negative affect, chronic pain, and drug craving. This constellation of outcome variables represents a more comprehensive appraisal of the quality of life and quality of recovery than is typically assessed in OUD clinical trials. To date, there are very few clinical trials or experimental studies aimed at improving sleep health in OUD patients, either as a means of improving stress, affect, and craving outcomes, or as a potential mechanistic target to reduce opioid withdrawal and drug use behaviors. As such, the direct impact of sleep improvement in OUD patients is largely unknown, yet mechanistic and clinical research suggests that therapeutic interventions that target sleep are a promising avenue to improve OUD treatment.
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