The Relevance of Dual Diagnoses among Drug-Dependent Patients with Sleep Disorders

Abstract

Background: Sleep disorders are often associated with drug use. Nearly 70% of patients admitted for detoxification report sleep problems. Dual disorder (DD) is the comorbidity between mental disorders in general and disorders related to psychoactive substance use. The association between substance use and sleep disorders (SD) appears to be bidirectional. Our objective is to analyze the association between sleep disturbance history and drug use pattern (alcohol, cannabis, opioids, and cocaine). Methods: Analysis of data in the first interview at the Addictions Unit of the Department of Psychiatry at the University of Salamanca Health Care Complex between October 2017 and January 2020. The sample consists of 398 patients. We studied the association between different variables: origin of patients (Inpatient Dual Diagnosis Detoxification Unit (IDDDU) vs. Outpatient Drug Clinic (ODC), presence of affective disorder, psychotic disorder, type of drug used, and treatment. Results: Of patients with DD, 62% had more delayed sleep induction, sleep fragmentation, early awakening, and nightmares. Outpatients had more difficulty falling asleep because, in many cases, they had not previously sought any medical assistance. On the other hand, 67% of the patients with insomnia presented depression. Conclusions: There is evidence of a harmful association between DD and SD.

Changes in substance use and engagement in gaming/gambling in persons with severe mental illness during the COVID-19 pandemic and earthquakes: a community study in two points

“…It is worth noting that environmental stressors, which can contribute to mental ill-health and maladaptive coping responses, including substance use, played a significant role in the context of the COVID-19 pandemic and earthquakes (44,45). The documented increase in depression, anxiety, and stress symptoms during these challenging times aligns with findings from other studies (46)(47)(48). Importantly, depression and anxiety symptoms have known associations with addictive behavior (46), while stress is independently associated with SMI (49).…”

Gender differences in sleep quality among Iranian traditional and industrial drug users

“…Drug use is a complex phenomenon involving various factors, such as emotional states, interpersonal relationships, environmental influences, and physical symptoms ( Kaviyani et al, 2023 ), and its relationship with sleep disorders is bidirectional ( Edwards et al, 2015 ). Nearly 70% of patients hospitalized for substance abuse detoxification report sleep problems ( Roncero et al, 2020 ). A high prevalence of sleep disturbances has been documented among chronic drug users, including methamphetamine, heroin, and ketamine users ( Li et al, 2018 ; Tang et al, 2015a , Tang et al, 2015b , Tang et al, 2015c ; Chen et al, 2017 ), as well as individuals with behavioral addictions, such as Internet addiction ( Alimoradi et al, 2019 ) and Instagram addiction ( D'Souza and Negahban, 2019 ).…”

Circadian rhythmicity in schizophrenia male patients with and without substance use disorder comorbidity

“…SUD is especially prevailing in patients with schizophrenia (SZ); prevalence rates of SUD in patients with psychotic spectrum disorders are around 50% [ 2 ]. This comorbidity, termed dual schizophrenia (SZ +), is also more frequent in men [ 3 ] and linked to worse sociodemographic profile and clinical severity [ 4 ]. In patients with SZ + , poorer therapeutic results and less adherence to treatment was observed [ 5 ], as well as more suicide attempts [ 6 ] and an earlier onset of SUD and SZ [ 7 ] compared to those with single diagnosis.…”

“…Alterations in circadian rhythms have been observed in patients with SUD even after months of abstinence, being the most frequent a phase delay (eveningness) and a reduction in amplitude [ 15 ]. These patients complain about the quality of their sleep and sleep disturbances which do not always respond to medication [ 3 ]. In this sense, imposing stable schedules during SUD treatment is a positive factor in the recovery of circadian rhythmicity, which is better in residential vs. outpatient treatment [ 16 ].…”