Sleep and Rest-Activity Rhythms in Recovering Patients with Severe Concurrent Mental and Substance Use Disorder: A
Myriam Juda1,2,3, Joanna Pater1,2,4, Ralph E Mistlberger1
1Sleep and Circadian Neuroscience Laboratory, Department of Psychology, Simon Fraser University, Burnaby, Canada.
Journal of Dual Diagnosis
|December 29, 2022
Summary
This study reveals significant sleep and circadian rhythm disruptions in patients with co-occurring mental health and substance use disorders. These disturbances correlate with psychiatric symptom severity, highlighting the need for integrated treatment approaches.
Area of Science:
- Neuroscience
- Psychiatry
- Sleep Medicine
Background:
- Mental health and substance use disorders frequently co-occur with sleep and circadian rhythm disturbances.
- The combined impact of these disorders on sleep architecture and rest-activity patterns is not well understood.
- This study offers a quantitative assessment of sleep and circadian rhythms in inpatients with complex concurrent disorders.
Purpose of the Study:
- To quantitatively assess sleep and rest-activity rhythms in inpatients with co-occurring mental health and substance use disorders.
- To examine how substance use categories (stimulant vs. stimulant and opioid) and psychiatric diagnoses (psychotic vs. mood disorder) influence these rhythms.
- To explore the relationship between sleep/circadian rhythms and psychiatric functioning (fatigue, symptom severity, impulsiveness).
Main Methods:
- 44 inpatients (20-60 years) wore wrist accelerometers for 5-70 days.
- Participants completed questionnaires on chronotype and psychiatric functioning.
- Analysis considered treatment influences: length of stay, days of abstinence, and sedative load.
Main Results:
- Participants showed excessive sleep duration, frequent nighttime awakenings, and advanced rest-activity phase, linked to sedative load.
- Elevated sleep disruptions were observed in individuals with a history of opioid use.
- Patients with psychotic disorders exhibited the longest sleep duration and most fragmented rest-activity patterns.
- Higher circadian rhythm amplitude correlated with greater psychiatric symptom severity, fatigue, and later chronotype.
Conclusions:
- This pilot study highlights prevalent and severe sleep and circadian rhythm disturbances in individuals with complex concurrent disorders.
- Findings underscore the need for further research into the role of sleep in the disease and recovery processes for this population.
- Integrated interventions addressing sleep and circadian health may be crucial for managing these complex conditions.
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