Sleep alterations in substance use disorders: a systematic review and meta-analysis

Area of Science:

• Neuroscience
• Psychiatry
• Sleep Medicine

Background:

• Sleep disturbances are prevalent in substance use disorders (SUDs), often persisting post-abstinence and impeding recovery.
• Existing research on substance-specific sleep abnormalities yields mixed results, necessitating further investigation.

Purpose of the Study:

• To systematically review and meta-analyze sleep-related abnormalities in individuals with alcohol (AUD), benzodiazepine (BUD), cannabis (CaUD), cocaine (CoUD), methamphetamine (MUD), nicotine (NUD), and opioid (OUD) use disorders.

Main Methods:

• A systematic search of major databases (Embase, PsycINFO, PubMed, Scopus, Web of Science) was conducted.
• Included 43 publications with ~7500 participants, utilizing objective (polysomnography) and subjective (PSQI) sleep measures.
• Data were meta-analyzed following a pre-registered protocol (PROSPERO: CRD42024531160).

Main Results:

• Reduced total sleep time (TST) observed in AUD, NUD, and OUD.
• Decreased slow-wave sleep (SWS) noted in AUD and CoUD.
• Poorer sleep quality (PSQI) reported in AUD, CoUD, and NUD.
• Insufficient data for CaUD meta-analysis; no studies met criteria for BUD or MUD.

Conclusions:

• Specific addictive substances are linked to distinct sleep alterations, with some drugs affecting both objective and subjective sleep parameters.
• Findings highlight convergence and divergence in substance-sleep relationships, underscoring the need for targeted interventions.
• Further meta-analytic research is recommended to elucidate complex sleep-substance interactions.