Insomnia Symptoms in Patients With Substance Use Disorders During Detoxification and Associated Clinical Features

Abstract

Background: Insomnia is highly prevalent in patients with substance use disorders (SUD), and it has been related to a worse course of addiction. Insomnia during detoxification in a hospital has not been adequately studied. This study aims to compare sociodemographic, clinical, and psychopathological characteristics of SUD patients undergoing a detoxification program, by comorbidity and insomnia symptoms. Methodology: We recruited 481 patients who received pharmacological and psychotherapeutic treatment for detoxification. They were evaluated through semi-structured interviews, standardized questionnaires, and a specific sleep log. A bivariate and multivariate analysis of the data was performed. Results: Insomnia was reported by 66.5% patients, with sleep-maintenance insomnia the most frequent issue, followed by early morning awakening and sleep-onset insomnia. Patients with alcohol use disorder and cannabis use disorder had higher prevalence of sleep-onset insomnia. Patients with cocaine and heroin use disorder had higher prevalence of sleep-maintenance insomnia. Independent factors that allowed the identification of insomnia symptoms included being female (OR: 3.43), polysubstance use (OR: 2.85), comorbid anxiety disorder (OR: 2.02), and prior admission for detoxification (OR: 1.22). Conclusions: Insomnia symptoms are very prevalent in patients admitted for detoxification. The diagnosis and therapeutic strategies for the insomnia symptoms should be improved, especially in women and in patients with greater addiction severity and with anxiety disorders.

The Association of P300 Components With Clinical Characteristics and Efficacy of Pharmacotherapy in Alcohol Use Disorder

“…Insomnia is highly prevalent in patients with AUD, and it has been related to a worse course of addiction. Patients with AUD had higher prevalence of sleep-onset insomnia ( 56 ). Patients with a moderate alcohol withdrawal syndrome also presented a lower percentage of slow-wave sleep, indicating that alcohol withdrawal syndrome severity should be considered as a critical factor for the development of non-rapid eye movement sleep alterations ( 57 ).…”

Inadequate sleep & obesity: Breaking the vicious cycle

“…39 People with cocaine and heroin use disorder tend to have more sleep-maintenance insomnia. 40 In contrast, those with alcohol or cannabis use disorder tend to have more sleeponset insomnia. 40 Not only do illicit drugs interrupt sleep, but daily tobacco use also has been correlated with increased insomnia and shorter sleep duration since nicotine is a stimulant.…”

“…40 In contrast, those with alcohol or cannabis use disorder tend to have more sleeponset insomnia. 40 Not only do illicit drugs interrupt sleep, but daily tobacco use also has been correlated with increased insomnia and shorter sleep duration since nicotine is a stimulant. 41 Insomnia is commonly treated with sedative antidepressants and hypnoticseg, mirtazapine and olanzapine-that contribute to weight gain.…”

Comparative feasibility and preliminary efficacy of CBT for insomnia among adults seeking and not seeking addiction treatment

“…Rates of clinically significant sleep disturbance range from ~60% to 75% among patients in treatment for SUD (Chakravorty et al, 2016; Grau‐Lopez et al, 2020). The prevalence of self‐medication for sleep problems with substances is also concerning, with rates ranging from 11% to 30% for alcohol (Goodhines et al, 2019) and as high as ~ 70% for cannabis (Bachhuber et al, 2019; Graupensperger et al, 2022).…”