Life‐time history of insomnia and hypersomnia symptoms as correlates of alcohol, cocaine and heroin use and relapse among adults seeking substance use treatment in the United States from 1991 to 1994

Abstract

Aims To examine the association between a lifetime history of insomnia and hypersomnia compared with no sleep disturbance and substance use patterns and amounts before and after a substance use treatment episode. Design Secondary analysis of data from the Drug Abuse Treatment Outcome Studies conducted from 1991 to 1994. Setting Data were collected at 96 substance use treatment programs in 11 United States cities including short-term in-patient, long-term residential, methadone maintenance, and outpatient drug-free treatment modalities. Participants Study samples included 7,168 adults at treatment entry and 2,965 at 12 months post-treatment entry whose primary substance use at entry was alcohol (14.7%), cocaine (62.7%), or heroin (22.6%). Measurements Lifetime history of insomnia and hypersomnia was assessed via self-report. Type and frequency of substance use were assessed at treatment entry. Substance use was also assessed 12 months following treatment completion. Associations were examined using linear and logistic regression with age, sex, race, education level, depression history, treatment modality, and in-treatment substance use as covariates. Findings Lifetime history of insomnia, hypersomnia, both or neither was reported by 26.3%, 9.5%, 28.0% and 36.2% of participants, respectively. Compared with no sleep disturbance, lifetime insomnia and hypersomnia were associated at treatment entry with unique substance use patterns and a higher frequency of any substance use (p < .001). All types of sleep disturbance were associated with higher rates of cocaine use at 12-month post-entry (ORs: 1.30–1.57). Conclusions There is evidence of an adverse association between substance use and sleep disturbance including higher frequency of all substance use before substance abuse treatment and higher rates of cocaine use after a treatment episode.

Development and early validation of a patient-reported outcome measure to assess sleep amongst people experiencing problems with alcohol or other drugs

“…For example, poor education, low income, and unemployment tend to be high across both sexes, with some evidence that women may be better than men at managing the finances they do have once substance use stops [ 3 , 58 ]. In terms of differences between mental health and the two sleep factors, there is a well-known association between poor mental health and the general sleep issues comprising factor 1 [ 59 , 60 ]. There is, however, no current evidence of an association between mental health and the items comprising SRSP (factor 2).…”

The prevalence of the sleep disturbances among the patients with substance use disorders

“…Ðåçóëüòàòû èññëåäîâàíèé ðÿäà äðóãèõ àâòîðîâ óêàçûâàþò íà òî, ÷òî íåêîòîðûå ïàöèåíòû ïðîäîëaeàþò ñîîáùàòü î íàðóøåíèÿõ ñíà, íåñìîòðÿ íà äîñòèaeåíèå ñòàáèëüíîé ðåìèññèè (25%), à òàêaeå ïðè ñíèaeåíèè ïîòðåáëåíèÿ àëêîãîëÿ èëè óìåðåííîì óïîòðåáëåíèè àëêîãîëÿ (8%) [11]. Èçâåñòíî, ÷òî äëÿ ïàöèåíòîâ ñ àëêîãîëüíûì çàáîëåâàíèåì èíñîìíèÿ ÿâëÿåòñÿ ôàêòîðîì ðèñêà ðåöèäèâà [13,14]. Î÷åâèäíî, íåîáõîäèìî ïðîâåäåíèå ëîíãèòóäèíàëüíûõ èññëåäîâàíèé ïàöèåíòîâ ñ ñèíäðîìîì çàâèñèìîñòè îò àëêîãîëÿ â ñòàäèè ðåìèññèè äëÿ îöåíêè ñâÿçè ìåaeäó íàðóøåíèÿìè ñíà è ôàçàìè àääèêòèâíîãî çàáîëåâàíèÿ (ðåìèññèé è ðåöèäèâîì).…”

Sleep and neuropsychiatric illness

“…The Epidemiologic Catchment Area study was the first high-profile data demonstrating that insomnia was a strong predictor of incident mood disorders, suggesting that sleeplessness was thus "an opportunity for prevention". This type of "bidirectional" relationship with insomnia has been demonstrated (although not equivocally) over the last 30 years for a number of neuropsychiatric disorders, including bipolar disorder [3], anxiety disorders [4], PTSD [5], substance use disorders [6], and Alzheimer's disease [7]. Sleep disturbance has also been established as a risk for transdiagnostic symptoms such as suicidality and pain [8,9].…”