Sleep disruption, stress, and craving during inpatient treatment for opioid use disorder

There is a bidirectional relationship between sleep disturbances and opioid misuse, and individuals with opioid use disorder (OUD) often experience poor sleep and insomnia. We aimed to characterize the relationship between sleep, craving, and negative affect among individuals with OUD seeking inpatient detoxification.

Adults receiving inpatient stabilization and detoxification treatment for OUD (N = 84) completed self-report measures of sleep and a standardized stress induction (the Computerized Mirror-Tracing Persistence Task) and rated their opioid craving and negative affect pre- and post-stressor. We examined whether sleep in the prior night and past two-week insomnia were associated with emotional stress reactivity and stress-induced craving.

Participants reported high levels of insomnia in the prior two weeks and shorter than recommended prior night sleep duration. There were no significant associations between sleep characteristics and baseline craving and pre-stressor negative affect. Greater insomnia severity in the past two weeks was associated with greater stress-induced craving and negative affect, past-night sleep duration was not.

Insomnia over a two-week period, but not past-night sleep, was associated with increased craving and negative affect following stress, suggesting that disturbed sleep may be an important risk factor in early recovery. Replication and extension with objective measures of sleep will be needed to better understand these associations and their impact on relapse and recovery.