Clinical correlates of drug‐related dreams in opioid use disorder

Abstract

Background and Objectives Drug‐related dreams are commonly reported by individuals in treatment for substance use disorders, which may be distressing. Existing evidence suggests that dream recollection may be influenced by clinically relevant phenomena, such as opioid use and withdrawal, general sleep disturbance, affective symptoms, and chronic pain. However, very few studies have explored drug‐related dreams among individuals who screened positive for opioid use disorder (OUD). Methods Adults recruited from Amazon Mechanical Turk (MTurk) who screened positive for OUD (N = 154) completed a questionnaire about drug‐related dreams, as well as measures assessing sleep, opioid use history, stress, anxiety, and chronic pain. χ2 analyses, one‐way analysis of variance, and bivariate correlations, correcting for the false discovery rate, were used as appropriate to explore correlates of (1) recollecting a drug‐related dream, and (2) experiencing post‐dream craving and distress. Results Individuals who recollected a past‐week drug‐related dream were more likely to report other recent sleep disturbances, including poorer sleep quality, greater insomnia symptoms, and a higher risk for sleep apnea. Post‐dream craving and distress were both associated with greater insomnia symptoms, poor sleep hygiene behaviors, and greater anxiety symptoms. Individuals who had ever experienced a drug‐related dream (recently, or in their lifetime) were more likely to report a history of severe withdrawal, overdose, and intravenous opioid use. Conclusion and Scientific Significance Drug‐related dreams were common among individuals in the present sample and were related to other clinically relevant phenomena. Interventions that treat co‐occurring OUD, pain, sleep symptoms, and affective symptoms may improve overall well‐being in this population.

Morphine pharmacokinetics and opioid transporter expression at the blood-retina barrier of male and female mice

“…As with opioid-mediated antinociception, the relationship between opioids, sleep/wake disturbances and sex is still being unraveled (Tripathi et al, 2020;Huhn and Finan, 2021). Some evidence suggests women are more likely to experience opioid-induced sleep disturbances (OISD) (Finan et al, 2020;Ellis et al, 2022). Importantly, OISD are emerging as a promising therapeutic target for opioid use disorder (Huhn and Finan, 2021).…”

Anxiety symptoms in Chinese people who use methamphetamine: Prevalence, demographics, and clinical characteristic

“…A recent study of patients with opioid use disorder (OUD) reported that recalling drug-related dreams from the past week may report more sleep disturbances, including poorer sleep quality, and more severe insomnia symptoms. Substantial increases in drug cravings following dreams have been associated with greater anxiety symptoms [50]. Sleep duration and disorders can affect anxiety symptoms, and similarly, increased anxiety level can negatively affect sleep; for example, excessive worry about insomnia may exacerbate sleep disturbances [51].…”

Pain catastrophizing moderates the relationship between chronic pain and insomnia severity in persons with opioid use disorder

“…To be eligible, they needed to be over 18 years old and currently in treatment or recovery for OUD. For additional information, see Ellis et al (2022a). The study was formally submitted to and acknowledged by the Johns Hopkins School of Medicine Institutional Review Board as exempt from human subjects research due to the deidentified nature of data collection.…”

“…Insomnia is a common co-occurring condition in OUD, as well as a known side effect of opioid withdrawal (Huhn et al, 2022;Ellis et al, 2022a). In order to sleep, some individuals resort to using opioids to prevent this symptom of withdrawal.…”

“…Chronic pain is a prevalent co-occurring condition in OUD and is associated with increased risk of sleep disturbances (Martinez et al, 2020). Additionally, chronic pain is often not addressed in opioid treatment programs, and many individuals with cooccurring chronic pain and OUD are more likely to report pain as a reason for OUD recurrence (Ellis et al, 2022b). As a result, chronic pain can continue to impact both sleep and opioid use, undermining otherwise effective treatments.…”