Polysomnographic measures of sleep in cocaine dependence and alcohol dependence: Implications for age‐related loss of slow wave, stage 3 sleep

Abstract

Background and aimsSleep disturbance is a prominent complaint in cocaine and alcohol dependence. This controlled study evaluated differences of polysomnographic (PSG) sleep in cocaine‐ and alcohol‐dependent subjects, and examined whether substance dependence interacts with age to alter slow wave sleep and rapid eye movement (REM) sleep.DesignCross‐sectional comparison.SettingLos Angeles and San Diego, CA, USA.ParticipantsAbstinent cocaine‐dependent subjects (n = 32), abstinent alcohol‐dependent subjects (n = 73) and controls (n = 108); mean age 40.3 years recruited 2005–12.MeasurementsPSG measures of sleep continuity and sleep architecture primary outcomes of Stage 3 sleep and REM sleep. Covariates included age, ethnicity, education, smoking, body mass index and depressive symptoms.FindingsCompared with controls, both groups of substance dependent subjects showed loss of Stage 3 sleep (P < 0.001). A substance dependence × age interaction was found in which both cocaine‐ and alcohol‐dependent groups showed loss of Stage 3 sleep at an earlier age than controls (P < 0.05 for all), and cocaine‐dependent subjects showed loss of Stage 3 sleep at an earlier age than alcoholics (P < 0.05). Compared with controls, REM sleep was increased in both substance‐dependent groups (P < 0.001), and cocaine and alcohol dependence were associated with earlier age‐related increase in REM sleep (P < 0.05 for all).ConclusionsCocaine and alcohol dependence appear to be associated with marked disturbances of sleep architecture, including increased rapid eye movement sleep and accelerated age‐related loss of slow wave, Stage 3 sleep.

Is biological aging accelerated in drug addiction?

“…Such lifestyle factors may mediate aging-related mechanisms rather than being directly causally inducing accelerated aging. For example, cocaine and alcohol addiction are associated with robust alterations in sleep architecture, including disturbances in slow-wave sleep and rapid eye movement (REM), which has implications for several age-related diseases, since sleep contributes to the homeostatic regulation of the neuroendocrine and immune systems [14] [e.g., the amount of REM sleep correlates with the production of the proinflammatory cytokines interleukin (IL)-6 and tumor necrosis factor (TNF)-α [15]].…”

Altered activity-based sleep measures in rhesus monkeys following cocaine self-administration and abstinence

“…Nevertheless, it cannot be excluded that the lack of correlation of sleep and cognitive measures is related to a limited number of subjects. Future studies with polysomnography could address whether individual sleep stages show similar or potentially more protracted disruptions with repeated cocaine self-administration (Irwin et al, 2016). …”

Sleep disturbance in substance use disorders and comorbid chronic viral infections

“…The recent study by Irwin et al . provides an important step in characterizing sleep disturbances during early abstinence in adults with cocaine or alcohol dependence. However, in an attempt to impose more controlled conditions in their polysomnographic investigation, research participants with evidence of HIV or hepatitis C virus (HCV) were excluded from the study.…”

“…This commentary goes beyond the discussion by Irwin et al . and considers how sleep architecture might be affected in the context of substance use disorders and comorbid chronic viral infections. This is an important population to study, as these illnesses commonly co‐occur, and chronic viral infections can contribute to central nervous system (CNS) dysfunction (i.e.…”

“…Irwin et al . discuss how activation of specific inflammatory pathways play a role in the increases in REM sleep observed in substance use disorders, such as increases in mononuclear cell production of interleukin (IL)‐6 and tumour necrosis factor (TNF)‐α—cytokines that are associated with impairments in mood, cognition and sleep as well as with blood–brain barrier integrity and viral neuroinvasion . Indeed, HIV and/or HCV infection of the brain may contribute to sleep disruption and neuropsychiatric impairments, particularly in adults with a history of substance abuse (e.g.…”