Acute heroin abstinence in man: I. Changes in behavior and sleep

The purpose of this study was to examine overt behavioral characteristics and sleep during acute heroin abstinence in man. Both heroine-dependent patients and drug-free control subjects were observed and monitored on a 24-hour per day basis for 5 to 7 days. Observational data were analyzed for frequency of occurrence of various behaviors including the signs and symptoms of withdrawal. Electroencephalographic (EEG) data were scored into awake and sleep stages according to standard techniques. The heroin-dependent subjects generally displayed a higher number of observations across all recording days as compared to the controls. In addition, the signs and symptoms of withdrawal for these patients peaked on day 1 or day 2 and then declined over the remaining recording days. The EEG state data showed an increase in waking and decrease in both slow wave and REM sleep during acute heroin withdrawal. Total sleep was maximally suppressed on withdrawal days 2 and 3 and was still below normal control values on withdrawal days 5 - 7. REM sleep was more disrupted than slow-wave sleep during withdrawal from heroin. Results of this study indicate that heroin withdrawal produces a differential action upon central nervous system structures responsible for the various states of sleep, waking and related behaviors.