Objective sleep outcomes in randomized-controlled trials in persons with substance use disorders: A systematic review

Huhn, Andrew S.; Dunn, Kelly E.; Ellis, Jennifer D.; Sholler, Dennis J.; Tabaschek, Paula; Burns, Rachel; Strain, Eric C.

doi:10.1016/j.drugalcdep.2022.109509

Cited by 5 publications

(2 citation statements)

References 73 publications

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“…78 There has also been substantial investment in technologies that track prominent conditions that serve as meaningful comorbidities for persons with OUD, such as insomnia. 79 These technologies could be pivoted or applied for persons receiving buprenorphine to improve their quality of life and treatment retention. Another area of rapid technological innovation is digital therapeutics, or web/app-based structured programs that have recently been provided clearance pathways by the FDA.…”

Section: Methods To Improve Provider Retention and Confidencementioning

confidence: 99%

Availability and Opportunities for Expansion of Buprenorphine for the Treatment of Opioid Use Disorder

McKendrick,

Stull,

Sharma

et al. 2024

Semin Neurol

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There is an urgent need to expand access to treatment for persons with opioid use disorder (OUD). As neurologists may frequently encounter patients with chronic pain who have developed OUD, they are in a position to serve as advocates for treatment. Buprenorphine is the most scalable medication for OUD in the United States, yet expansion has plateaued in recent years despite growing treatment needs. Reluctance of providers to establish treatment with new patients, challenges with rural expansion, stigma related to buprenorphine-based care, and pharmacy pressures that incentivize low dispensing and inventories may have stalled expansion. This review introduces these challenges before outlining actionable and evidenced-based strategies that warrant investigation, including methods to improve patient access to care (remotely delivered care, mobile delivery programs, Bridge programs) and provider retention and confidence in prescribing (expert consults, Extension for Community Healthcare Outcomes, a telementoring model, hub-and-spoke services), as well as novel innovations (virtual reality, artificial intelligence, wearable technologies). Overall, fortifying existing delivery systems while developing new transformative models may be necessary to achieve more optimal levels of buprenorphine treatment expansion.

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Section: Methods To Improve Provider Retention and Confidencementioning

confidence: 99%

Availability and Opportunities for Expansion of Buprenorphine for the Treatment of Opioid Use Disorder

McKendrick,

Stull,

Sharma

et al. 2024

Semin Neurol

Self Cite

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“…In healthy sleepers, actigraphic measurement of sleep and wake has comparable accuracy to PSG [8]. Although actigraphy has been utilised in pre-clinical laboratory studies, no clinical trials investigating treatments of MA use or dependence have included actigraphy, nor attempted to combine subjective and objective sleep measures [9].…”

Section: Introductionmentioning

confidence: 99%

Measuring Objective and Subjective Sleep during Lisdexamfetamine Treatment of Acute Methamphetamine Withdrawal: A Feasibility Study

Acheson,

Gordon,

McKetin

et al. 2024

Eur Addict Res

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Introduction: Sleep disturbance is common during methamphetamine (MA) use and withdrawal; however, the feasibility of combined subjective-objective measurement of sleep-wake has not been shown in this population. Actigraphy is a well-established, non-invasive measure of sleep-wake cycles with good concordance with polysomnography. This study aimed to investigate the feasibility and utility of using actigraphy and sleep diaries to investigate sleep during MA withdrawal. Methods: We conducted a feasibility and utility study of actigraphy and sleep diaries during a clinical trial of lisdexamfetamine for MA withdrawal. Participants were inpatients for 7 days, wore an actigraph (Philips Actiwatch 2) and completed a modified Consensus Sleep Diary each morning. Participants were interviewed between days 3–5. Results: Ten participants (mean age 37 years, 90% male) were enrolled. No participant removed the device prematurely. Participants interviewed (n = 8) reported that the actigraph was not difficult or distracting to wear or completion of daily sleep diary onerous. Actigraphic average daily sleep duration over 7 days was 568 min, sleep onset latency 22.4 min, wake after sleep onset (WASO) 75.2 min, and sleep efficiency 83.6%. Sleep diaries underreported daily sleep compared with actigraphy (sleep duration was 56 min (p = 0.008) and WASO 47 min (p < 0.001) less). Overall sleep quality was 4.4 on a nine-point Likert scale within the diary. Conclusions: Continuous actigraphy is feasible to measure sleep-wake in people withdrawing from MA, with low participant burden. We found important differences in self-reported and actigraphic sleep, which need to be explored in more detail.

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Patient-reported sleep outcomes in randomized-controlled trials in persons with substance use disorders: A systematic review

Huhn

Ellis

Dunn

et al. 2022

Drug and Alcohol Dependence

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Objective sleep outcomes in randomized-controlled trials in persons with substance use disorders: A systematic review

Cited by 5 publications

References 73 publications

Availability and Opportunities for Expansion of Buprenorphine for the Treatment of Opioid Use Disorder

Availability and Opportunities for Expansion of Buprenorphine for the Treatment of Opioid Use Disorder

Measuring Objective and Subjective Sleep during Lisdexamfetamine Treatment of Acute Methamphetamine Withdrawal: A Feasibility Study

Patient-reported sleep outcomes in randomized-controlled trials in persons with substance use disorders: A systematic review

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