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

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

doi:10.1016/j.drugalcdep.2022.109508

Cited by 9 publications

(7 citation statements)

References 105 publications

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“…Our findings are in line with epidemiological studies that have found sleep disturbances to be frequently reported as a side-effect of AAS use (Eklöf et al, 2003;Ip et al, 2011;Korkia and Stimson, 1997;Parkinson and Evans, 2006). Using two widely used assessment tools, we found that the AAS group scored significantly higher than controls on most subscales, besides sleep latency, suggesting that AAS use or associated factors may have a broad impact on different aspects of sleep.…”

Section: Aas Use Is Associated With Poor Sleep Qualitysupporting

confidence: 91%

“…The prevalence is much higher, however, in certain subpopulations such as athletes (13.4%), recreational sportspeople (18.4%), and substance use patients (28%) (Havnes et al, 2019;Sagoe and Pallesen, 2018). Sleep pathology is often mentioned as one of the reported sideeffects of AAS use and is a common clinical observation (Eklöf et al, 2003;Ip et al, 2011;Korkia and Stimson, 1997;Parkinson and Evans, 2006). About half of men who use AAS reported insomnia as a subjective side effect (Parkinson and Evans, 2006), and polysomnographic measurements show that men who use AAS have reduced sleep efficiency compared to controls (Venâncio et al, 2008).…”

Section: Introductionmentioning

confidence: 99%

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Sleep pathology and use of anabolic androgen steroids among male weightlifters in Norway

Klonteig¹,

Scarth²,

Bjørnebekk³

2023

Preprint

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Use of anabolic androgenic steroids (AAS) causes drastic changes in hormonal milieu and is associated with a range of medical and psychological consequences. Sleep pathology is a common side-effect of AAS use but few have studied these relations. This study examined the relationship between AAS use, psychological distress and sleep quality, and how phases of heavy use and abstinence influence sleep. The Pittsburgh-Sleep-Quality-Index (PSQI) and Jenkins Sleep Scale (JSS) were used to assess sleep quality, and psychological distress was measured with the Hopkins Symptoms Checklist (HSCL). Participants comprised men who have previous or current long-term use of AAS (n=68) and non-using weightlifting controls (WLC) (n=58), where a subgroup of participants (n= 22) was monitored over ~6 months during phases of AAS use and withdrawal. Group differences on PSQI and JSS were evaluated with Kruskal-Wallis H tests, and the mediating role of psychological distress was evaluated using structural equation modeling. Linear mixed models were used to assess the role of AAS use and withdrawal on sleep quality. Among the AAS group, 65% reported sleep problems as a side effect, and 43% had used sleep medication. PSQI scores showed significantly lower sleep quality in the AAS group compared to WLC (p<0.001) on all subscales except “sleep latency”. Furthermore, sleep quality was significantly poorer during withdrawal-phases than periods with AAS use (p<.001). Our findings provide key insight into sleep disturbances among men who use AAS, suggesting a link between sleep disturbances and hormone levels that deviate from physiologically normal levels in both directions.

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Section: Aas Use Is Associated With Poor Sleep Qualitysupporting

confidence: 91%

Section: Introductionmentioning

confidence: 99%

Sleep pathology and use of anabolic androgen steroids among male weightlifters in Norway

Klonteig¹,

Scarth²,

Bjørnebekk³

2023

Preprint

View full text Add to dashboard Cite

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“…Transcriptional rhythm alterations in both brain regions were linked to sleep and circadian rhythm traits in OUD [2], further supporting mechanistic relationships between sleep and circadian disruption in synaptic changes in opioid addiction [2,[14][15][16][17][18][19][20][21][22] To date, much of the work in postmortem human brain of subjects with OUD has used RNA-sequencing approaches, with few proteomics studies [13]. Transcriptomics and proteomics approaches provide different levels of biological information.…”

Section: Introductionmentioning

confidence: 94%

Circadian rhythm disruptions associated with opioid use disorder in the synaptic proteomes of the human dorsolateral prefrontal cortex and nucleus accumbens

Puig

Xue

Salisbury

et al. 2023

Preprint

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Opioid craving and the vulnerability to relapse is associated with severe and persistent disruptions to sleep and circadian rhythms. Investigations into the cellular and molecular pathways in the human brain underlying the relationship between circadian rhythms and OUD remain limited. In human subjects with OUD, previous transcriptomics work implicated a role for circadian regulation of synaptic processes in key cognitive- and reward-related brain regions, dorsolateral prefrontal cortex (DLPFC) and nucleus accumbens (NAc). To provide further insights into the synaptic alterations associated with OUD, we used mass-spectrometry based proteomics to deeply profile protein alterations in tissue homogenates and synaptosomes from both NAc and DLPFC of unaffected and OUD subjects. Between unaffected and OUD subjects, we identified 43 differentially expressed (DE) proteins in NAc homogenates and 55 DE proteins in DLPFC homogenates. In synaptosomes, we found 56 DE proteins in NAc of OUD subjects and 161 DE proteins in DLPFC. Examining synaptosome enrichment of specific proteins enabled us to identify brain region- and synapse-specific pathway alterations in NAc and DLPFC associated with OUD. Across both regions, we found OUD-associated protein alterations primarily in pathways involved in GABAergic and glutamatergic synaptic functions, as well as circadian rhythms. Using time-of-death (TOD) analyses, where the TOD of each subject is used as a time-point across a 24-hour cycle, we were able to map circadian-related changes in the synaptic proteomes in NAc and DLPFC associated with OUD. In OUD, TOD analysis revealed significant circadian changes in endoplasmic reticulum to Golgi vesicle-mediated transport and protein membrane trafficking in NAc synapses, accompanied by changes in platelet derived growth factor receptor beta signaling in DLPFC synapses. Together, our results lend further support for molecular disruption of circadian regulation of synaptic signaling in the human brain as a key factor in opioid addiction.

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“…Substance use disorder is significantly more common in UHR individuals ( Carney et al, 2017 ) and patients suffering from schizophrenia ( Hunt et al, 2018 ) than in the general population. Substance use is known to affect both WM microstructure ( Murray et al, 2017 ; Hampton et al, 2019 ) and sleep ( Huhn et al, 2022 ), as well as the risk of developing psychosis ( Murray et al, 2017 ; Murrie et al, 2020 ; Hjorthøj et al, 2021 ). A meta-analysis found lower FA in CC in individuals with a substance use disorder, however, it appeared dependent on the type of substance ( Hampton et al, 2019 ).…”

Section: Introductionmentioning

confidence: 99%

“…A meta-analysis found lower FA in CC in individuals with a substance use disorder, however, it appeared dependent on the type of substance ( Hampton et al, 2019 ). Studies have demonstrated that substance use worsens both the subjective experience of sleep quality and objective sleep-wake measures, including reduced total sleep time (TST) and increased Wake After Sleep Onset (WASO) ( Huhn et al, 2022 ). It is well-known that substance use can induce transient and dose dependent psychotic symptoms.…”

Section: Introductionmentioning

confidence: 99%

White matter microstructure and sleep-wake disturbances in individuals at ultra-high risk of psychosis

Rasmussen

Nordholm²,

Glenthøj³

et al. 2022

Front. Hum. Neurosci.

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AimWhite matter changes in individuals at ultra-high risk for psychosis (UHR) may be involved in the transition to psychosis. Sleep-wake disturbances commonly precede the first psychotic episode and predict development of psychosis. We examined associations between white matter microstructure and sleep-wake disturbances in UHR individuals compared to healthy controls (HC), as well as explored the confounding effect of medication, substance use, and level of psychopathology.MethodsSixty-four UHR individuals and 35 HC underwent clinical interviews and diffusion weighted imaging. Group differences on global and callosal mean fractional anisotropy (FA) was tested using general linear modeling. Sleep-wake disturbances were evaluated using the subjective measures disturbed sleep index (DSI) and disturbed awakening index (AWI) from the Karolinska Sleep Questionnaire, supported by objective sleep measures from one-night actigraphy. The primary analyses comprised partial correlation analyses between global FA/callosal FA and sleep-wake measures. Secondary analyses investigated multivariate patterns of covariance between measures of sleep-wake disturbances and FA in 48 white matter regions of interest using partial least square correlations.ResultsUltra-high risk for psychosis individuals displayed lower global FA (F = 14.56, p < 0.001) and lower callosal FA (F = 11.34, p = 0.001) compared to HC. Subjective sleep-wake disturbances were significantly higher among the UHR individuals (DSI: F = 27.59, p < 0.001, AWI: F = 36.42, p < 0.001). Lower callosal FA was correlated with increased wake after sleep onset (r = −0.34, p = 0.011) and increased sleep fragmentation index (r = −0.31, p = 0.019) in UHR individuals. Multivariate analyses identified a pattern of covariance in regional FA which were associated with DSI and AWI in UHR individuals (p = 0.028), but not in HC. Substance use, sleep medication and antipsychotic medication did not significantly confound these associations. The association with objective sleep-wake measures was sustained when controlling for level of depressive and UHR symptoms, but symptom level confounded the covariation between FA and subjective sleep-wake measures in the multivariate analyses.ConclusionCompromised callosal microstructure in UHR individuals was related to objectively observed disruptions in sleep-wake functioning. Lower FA in ventrally located regions was associated with subjectively measured sleep-wake disturbances and was partly explained by psychopathology. These findings call for further investigation of sleep disturbances as a potential treatment target.

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

Cited by 9 publications

References 105 publications

Sleep pathology and use of anabolic androgen steroids among male weightlifters in Norway

Sleep pathology and use of anabolic androgen steroids among male weightlifters in Norway

Circadian rhythm disruptions associated with opioid use disorder in the synaptic proteomes of the human dorsolateral prefrontal cortex and nucleus accumbens

White matter microstructure and sleep-wake disturbances in individuals at ultra-high risk of psychosis

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