Treatment of insomnia associated with alcohol and opioid use: a narrative review.

Autor: Akinnusi M; The Veterans Affairs Western New York Healthcare System, 3495 Bailey Avenue, Buffalo, NY 14215 USA.; Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, Jacob School of Medicine, Buffalo, USA., Martinson A; Behavioral Health Service, George Wahlen VA Medical Center, Salt Lake City, UT USA., El-Solh AA; The Veterans Affairs Western New York Healthcare System, 3495 Bailey Avenue, Buffalo, NY 14215 USA.; Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, Jacob School of Medicine, Buffalo, USA.; Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, Buffalo, NY USA.
Jazyk: angličtina
Zdroj: Sleep and biological rhythms [Sleep Biol Rhythms] 2024 Jul 15; Vol. 22 (4), pp. 429-445. Date of Electronic Publication: 2024 Jul 15 (Print Publication: 2024).
DOI: 10.1007/s41105-024-00544-x
Abstrakt: Substance use disorders (SUDs) are associated with profound sleep disturbances, including insomnia, sleep fragmentation, and circadian rhythm dysfunction resulting in serious mental and physical consequences. This minireview presents an overview of the neurocircuitry underlying sleep disturbances in SUDs and elaborates on treatment options with emphasis on alcohol use disorder (AUD) and opioid use disorder (OUD). A PubMed, Embase, CINAHL Plus, Cochrane, and Scopus search were conducted using sleep- and AUD/OUD related keywords from January 1st, 2000, to January 31st, 2023, with preferences for recent publications and randomized-controlled trials. A bidirectional relationship exists between insomnia and addiction with the status of each condition impacting the other in dictating clinical outcome. Existing evidence points to a resurgence of insomnia during detoxification, and unless treated satisfactorily, insomnia may lead to relapse. The discussion summarizes the strengths and limitations of cognitive behavioral therapy and pharmacological treatment for insomnia in SUDs covering evidence from both animal and clinical studies. The assumption of reestablishing normal sleep patterns by attaining and maintaining sobriety is misguided. Comorbid insomnia in patients with SUDs should be approached as an independent condition that requires its own treatment. Future clinical trials are needed with the aim of providing a resource for guiding clinical management of the many patients with insomnia and SUD.
Competing Interests: Conflict of interestNone.
(© This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply 2024.)
Databáze: MEDLINE
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