Sex Specific Sleep Parameters Among People With Substance Use Disorder

Abstract

IntroductionSleep can have substantial impacts in substance use disorder (SUD) pathogenesis, treatment, and recovery. Sex differences exist in both sleep and SUD, but how sleep is uniquely associated with SUD by sex is not known. The study objective was to compare, within sex, sleep parameters between individuals with SUD and non-substance misusing controls.MethodsSecondary analyses of a parent cross-sectional study examining the feasibility and acceptability of a novel neurocognitive phenotyping assessment battery were completed. SUD and control subjects were recruited through local advertising and an established research registry. Subjects with SUD were also recruited through a university-based outpatient SUD treatment clinic. Self-reported sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI). Sex-stratified t-tests compared sleep between SUD and control subjects while Crosstab analyses explored group differences in the proportion of individuals reporting poor sleep (defined as PSQI ≥ 5).ResultsData from 162 males (44 controls, 118 SUD) and 146 females (64 controls, 82 SUD) were included in the present study. For females only, a significantly lower proportion of controls reported PSQI-defined poor sleep than individuals with any SUD or specifically with opioid use disorder. Male, but not female, controls reported shorter sleep latency, longer sleep duration, and less sleep disturbance than males with each SUD type.Discussion/ImplicationsSleep holds promise as an avenue to address SUD within a biopsychosocial model. Future work at the intersection of SUD and sleep should prioritize investigations of their interplay with sex to identify targets for tailored SUD interventions.

Patient reported preferences for sleep interventions among women receiving buprenorphine for opioid use disorder

“…Importantly, the relationship between sleep disturbance and OUD outcomes may differ by sex, and although OUD remains more prevalent among men, this gap by sex is rapidly closing ( 9 ). Specifically, sleep disorders, especially insomnia, are more prevalent among women than men, and one meta-analysis found that females had a risk ratio of 1.41 of insomnia compared to men ( 10 ).…”

“…Proposed underlying mechanisms for this sleep disparity are numerous, ranging from the role of sex-specific hormones to the impact of gendered social factors that more commonly affect women ( 11 , 12 ). Therefore, the relationship between sleep and OUD is likely multifaceted with interactions with sex and other biopsychosocial factors ( 8 , 9 ).…”