Sleep affects every part of our daily lives. Disruptions in sleep quality can have profound impacts on cognitive function, learning, and memory; on regulation of metabolism and hormone secretion; on immune functions, and on cardiovascular health. An estimated 50-70 million individuals are living with a chronic sleep disorder such as difficulty initiating or maintaining sleep (insomnia), excessive daytime sleepiness (hypersomnia), and abnormal behaviors during sleep (parasomnia), and other issues.1 Emerging research at the intersection of sleep science and addiction medicine suggests that difficulties with sleep may disproportionately affect people with Opioid Use Disorder (OUD) and compound harms associated with opioid misuse. Indeed, sleep deficiency is present in approximately 65% of patients with OUD.2
Henry (Klar) Yaggi, MD, MPH; Declan Barry, PhD; Nancy Redeker, PhD, RN; Dustin Scheinost, PhD; and Stephen Baldassarri, MD, MHS are among researchers in affiliation with Yale School of Medicine, Yale School of Nursing (YSN), and the Yale Program in Addiction Medicine, seeking to better understand connections between sleep and OUD, and by extension ways in which sleep disorders may impact OUD treatment outcomes. Their new study supported by the National Institutes of Health Helping End Addiction Long-term (HEAL) Initiative, “Collaboration Linking Opioid Use Disorder and Sleep” (CLOUDS), is currently recruiting participants in the Greater New Haven area. The CLOUDS study will investigate potential biologic, psychiatric, and pharmacologic causal mechanisms between sleep deficiency and OUD, as well as contributing ecologic factors (e.g. psychosocial and family characteristics, environment) among patients on medications for Opioid Use Disorder. Says Dr. Yaggi, a Principal Investigator for the CLOUDS study, “Understanding the mechanisms of the relationship between sleep deficiency and OUD may be a key to unlocking better treatments for OUD.”
Five Facts About Sleep and Opioid Use
As our understanding of the relationship between sleep and OUD evolves, here are 5 things you should know about sleep, OUD and substance use:
1. Opioids can have negative impacts on when, how well, and how much you sleep
Use of opioids can contribute to increased wakefulness, decreased total sleep time, and decreased sleep quality.
2. The same brain circuits impaired by OUD are also impaired by sleep deficiency
Like OUD, sleep deficiency can impair your executive function (difficulty stringing together actions to meet long-term goals, difficulty organizing, analyzing and processing information) and reward processing (desire and craving for a reward). In cases where OUD and sleep deficiency are combined, individuals may experience worsened outcomes with respect to recurrent illicit drug use, difficulty engaging in treatment, and ongoing addiction.
3. People with OUD may be more likely to experience certain sleep disorders
4. Sleep deficiency can contribute to stress and negative mood including anxiety and depression
The impacts of sleep deficiency on stress levels and mood may exacerbate misuse of opioids or other substances and adversely affect OUD treatment outcomes
5 .Other substances can impact your sleep hygiene sleep, too
Nicotine, caffeine and other stimulants can contribute to wakefulness and sleep disruptions. Alcohol, a depressant, may promote initiation of sleep but it can disrupt the sleep cycle and achievement of deep sleep stages
Five Tips for Healthier Sleep
1. Limit use of electronic devices and television before bedtime.
- The artificial light produced by these devices can be stimulating. Turn off the screens at least 30 minutes before turning in for the night. Turn off the television during your sleep time.
2. Make your sleep environment comfortable, dark, and quiet.
- Adjust the temperature to your liking. Block out noise with earplugs or white noise, and light with blackout shades.
3. Consider the use of relaxing activities before bedtime to help you unwind from the day.
- Try playing music you enjoy or find soothing, taking a warm bath, or doing some light reading.
4. Avoid daytime napping if you can.
- If you must nap, limit naps to one hour. Do not nap after 3 pm.
5. Use your bed only for sleep, sex or recovering from illness.
- Limiting use of your bed to only these activities helps you to associate your bed with good sleep efficiency rather than not sleeping or frustration with not sleeping.
Coming Up Next
YSN, the Yale Center for Biobehavioral Health Research, and the Yale Program in Sleep Medicine are hosting the Sixth Annual Sleep & Symptom Research Symposium on Friday, April 30. The virtual event will feature Dr. Teresa Ward of the University of Washington and Dr. Samuel Kuna of the University of Pennsylvania as keynote speakers. Registration opens in mid-March.
The deadline to submit an abstract for the poster/data blitz presentations on research related to sleep, symptoms, or chronobiology is Friday, April 2. Abstracts may report completed research or research in progress that addresses sleep and sleep disturbance.
Abstracts must be no more than 350 words and organized as follows: title, authors/credentials, affiliations, and contact information. Include background of the study, aims/objectives, methods, results, and conclusions. Please use one-inch margins and Arial 12-point type. Submit your abstract here.
1 Kryger MH, Roth T, Dement WC. Principles and Practice of Sleep Medicine. 6th ed. Philadelphia, PA: Elsevier; 2017.
2 Dunn KE, Finan PH, Andrew Tompkins D, Strain EC. Frequency and correlates of sleep disturbance in methadone and buprenorphine-maintained patients. Addict Behav. 2018;76:8-14. Epub 2017/07/25. doi: 10.1016/j.addbeh.2017.07.016. PubMed PMID: 28735039; PMCID: PMC5614840.