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Obeid JM, Sadeghi JK, Wolf AS, Bremner RM. Sleep, Nutrition, and Health Maintenance in Cardiothoracic Surgery. Thorac Surg Clin 2024; 34:213-221. [PMID: 38944448 DOI: 10.1016/j.thorsurg.2024.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/01/2024]
Abstract
Cardiothoracic surgeons work in high-intensity environments starting in surgical training and throughout their careers. They deal with critical patients. Their routine procedures are delicate, require extensive attention to detail, and can have detrimental effects on patients' lives. Cardiothoracic surgeons are required to perform at their best capacity incessantly. To do this, they must safeguard their mental and physical well-being. Preserving health through sleep, nutrition, exercise, and routine medical checkups ensures a cardiothoracic surgeon's well-being. Great personal effort and discipline is required to maintain health in a busy schedule. We offer our best recommendations from expert peers in the field.
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Affiliation(s)
- Joseph M Obeid
- Department of Cardiothoracic Surgery, Temple University Hospital, 3401 N Broad Street, Parkinson Pavilion, Suite 501C, Philadelphia, PA 19140, USA
| | - John K Sadeghi
- Department of Cardiothoracic Surgery, Temple University Hospital, 3401 N Broad Street, Parkinson Pavilion, Suite 501C, Philadelphia, PA 19140, USA
| | - Andrea S Wolf
- New York Mesothelioma Program, Department of Thoracic Surgery, The Icahn School of Medicine at Mount Sinai, 1190 Fifth Avenue, Box 1023, New York, NY 10029, USA
| | - Ross M Bremner
- Norton Thoracic Institute, St. Joseph's Hospital and Medical Center, 500 W. Thomas Road, Suite 500, Phoenix, AZ 85013, USA; School of Medicine, Creighton University, Phoenix Health Sciences Campus, 3100 N Central Avenue, Phoenix, AZ 85012, USA.
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Hajak G, Vetter C, Wehling M. Neurexan Prescription Is Associated with Lower Risk of Sleep Disorder Recurrence and Depression Prevalence as Compared to Z-Drugs and Benzodiazepines: A Retrospective Database Analysis in Germany. Healthcare (Basel) 2024; 12:1413. [PMID: 39057556 PMCID: PMC11276089 DOI: 10.3390/healthcare12141413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2024] [Revised: 07/10/2024] [Accepted: 07/12/2024] [Indexed: 07/28/2024] Open
Abstract
Real-world evidence on the association between natural medicinal products and the recurrence of sleep disorders is currently limited, particularly when compared to the evidence reported for prescription hypnotics. In a retrospective cohort analysis, we investigated patients with sleep disorders prescribed either the natural medicinal product Neurexan (Nx4), benzodiazepines, or nonbenzodiazepines (Z-drugs) using the IQVIA Disease Analyzer database, which encompasses electronic medical records nationwide in Germany. A 1:1 matching procedure based on age, sex, prevalent depression, anxiety or adjustment disorder, and the number of medical consultations in the past 12 months resulted in four cohorts: patients prescribed Nx4 were matched with those prescribed Z-drugs (two cohorts with 8594 matched patients each), and another cohort of patients prescribed Nx4 were matched with those prescribed benzodiazepines (7779 matched pairs). Results from multivariable-adjusted Cox regression models demonstrated that Nx4 was associated with a significantly lower risk of recurrent sleep disorder diagnosis within 30-365 days after prescription compared to both Z-drugs (HR = 0.65, 95%CI = 0.60-0.70, p < 0.001) and benzodiazepines (HR = 0.85, 95%CI = 0.79-0.93, p < 0.001). Additionally, Nx4 was associated with a lower prevalence of depression compared to Z-drugs (HR = 0.90, 95%CI = 0.83-0.98, p = 0.020) and benzodiazepines (HR = 0.89, 95%CI = 0.82-0.97, p = 0.009). These findings suggest an association between Nx4 and improved sleep and mental health outcomes. However, due to inherent limitations in the study design, the causality of this relationship cannot be stated.
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Affiliation(s)
- Göran Hajak
- Clinic for Psychiatry, Psychosomatic Medicine and Psychotherapy, Sozialstiftung Social Foundation Bamberg, Teaching Hospital of the University of Erlangen, 96049 Bamberg, Germany
| | - Céline Vetter
- IQVIA Commercial GmbH & Co. KG, 60549 Frankfurt am Main, Germany
| | - Martin Wehling
- Medical Faculty Mannheim, University of Heidelberg, 68167 Mannheim, Germany
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Williams BR, Gamble MC, Singh N, Bryant CD, Logan BA, Logan RW. Sleep and circadian rhythm activity alterations during adolescence in a mouse model of neonatal fentanyl withdrawal syndrome. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.07.05.602239. [PMID: 39026736 PMCID: PMC11257457 DOI: 10.1101/2024.07.05.602239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/20/2024]
Abstract
Purpose Fentanyl, a highly potent synthetic opioid, is a major contributor to the ongoing opioid epidemic. During adulthood, fentanyl is known to induce pronounced sleep and circadian disturbances during use and withdrawal. Children exposed to opioids in utero are likely to develop neonatal opioid withdrawal syndrome, and display sleep disturbances after birth. However, it is currently unknown how neonatal opioid withdrawal from fentanyl impacts sleep and circadian rhythms in mice later in life. Methods To model neonatal opioid withdrawal syndrome, mice were treated with fentanyl from postnatal days 1 through 14, analogous to the third trimester of human gestation. After weaning, fentanyl and saline treated mice underwent non-invasive sleep and circadian rhythm monitoring during adolescence postnatal days 23 through 30. Results Neonatal fentanyl exposure led to reduced duration of wake and a decrease in the number of bouts of non-rapid eye movement sleep. Further, neonatally exposed mice displayed an increase in the average duration of rapid eye movement sleep bouts, reflecting an overall increase in the percent time spent in rapid eye movement sleep across days. Conclusions Neonatal fentanyl exposure leads to altered sleep-wake states during adolescence in mice.
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Brimvandi A, Ershad Nedaei S, Pourmotaabed A, Sahveisi K, Abdoli N, Ghazvini H, Khodamoradi M. Methamphetamine and REM sleep deprivation interact to affect behavioral performance in adult and adolescent rats. Brain Res 2024; 1841:149096. [PMID: 38936532 DOI: 10.1016/j.brainres.2024.149096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2024] [Revised: 06/18/2024] [Accepted: 06/24/2024] [Indexed: 06/29/2024]
Abstract
Drug addiction may result in sleep problems. Importantly, sleep deprivation (SD) is known as an important risk factor for relapse to drug abuse as SD mimics the effects of psychostimulants on dopamine system of the brain. Moreover, aging may affect sleep and drug addiction. This study, therefore, set out to assess the effects of methamphetamine (METH) and REM sleep deprivation (RSD) on locomotor activity, anxiety-like behavior and spatial memory in adult and adolescent rats. Adult and adolescent male Wistar rats received a neurotoxic METH regimen; four subcutaneous injections of 6 mg/kg, at 2 h intervals. Five days later, the animals underwent a 48-h RSD episode using the multiple platforms method. They were then examined using the open field (OF), elevated plus maze (EPM) and Y-maze tasks. We found that the METH and RSD paradigms showed synergistic effects to increase locomotion and risk-taking behavior in both adult and adolescent animals, while only adolescent rats revealed RSD-induced anxiety-like behavior. Moreover, adolescent animals revealed greater sensitization for vertical activity following METH plus RSD episode. In addition, METH and RSD paradigms revealed synergistic effects to impair spatial working memory, but neither METH nor RSD alone affected performance of animals in the Y-maze task. Our findings may indicate that there are important relationships between METH and RSD to induce hyperlocomotion, risk-taking behavior and spatial memory impairment, particularly in adolescent animals. Moreover, it seems that adolescent rats may be more susceptible to anxiety-like behavior and hyperlocomotion than adults.
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Affiliation(s)
- Aazam Brimvandi
- Department of Physiology, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Seyed Ershad Nedaei
- Department of Physiology, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Ali Pourmotaabed
- Department of Physiology, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Kaveh Sahveisi
- Sleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Nasrin Abdoli
- Substance Abuse Prevention Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Hamed Ghazvini
- Psychiatry and Behavioral Sciences Research Center, Addiction Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mehdi Khodamoradi
- Substance Abuse Prevention Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran.
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Borgatti DA, Rowlett JK, Berro LF. Effects of methamphetamine on actigraphy-based sleep parameters in female rhesus monkeys: Orexin receptor mechanisms. Drug Alcohol Depend 2024; 259:111285. [PMID: 38636173 PMCID: PMC11111337 DOI: 10.1016/j.drugalcdep.2024.111285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Revised: 03/05/2024] [Accepted: 04/01/2024] [Indexed: 04/20/2024]
Abstract
BACKGROUND The orexin system has been implicated as a mechanism underlying insomnia and methamphetamine-induced sleep disruptions, with a potential role for OX2 receptors in the sleep-modulating effects of orexin. The aim of the present study was to investigate the extent to which orexin receptors mediate the effects of acute methamphetamine administration on actigraphy-based sleep in female rhesus monkeys. METHODS Actigraphy-based sleep measures were obtained in female rhesus monkeys (n=5) under baseline and acute test conditions. First, morning (10h) i.m. injections of methamphetamine (0.03 - 0.56mg/kg) were administered to determine the effects of methamphetamine alone. Then, saline or methamphetamine (0.3mg/kg) were administered at 10h, and evening (17h30) oral treatments with vehicle, the non-selective orexin receptor antagonist suvorexant (1 - 10mg/kg, p.o.), or the OX2-selective orexin receptor antagonist MK-1064 (1 - 10mg/kg, p.o.) were given. The ability of suvorexant and MK-1064 (10mg/kg, p.o.) to improve actigraphy-based sleep was also assessed in a group of female monkeys quantitatively identified with "short-duration sleep" (n=4). RESULTS Methamphetamine dose-dependently disrupted actigraphy-based sleep parameters. Treatment with either suvorexant or MK-1064 dose-dependently improved actigraphy-based sleep in monkeys treated with methamphetamine. Additionally, both suvorexant and MK-1064 promoted actigraphy-based sleep in a group of monkeys with baseline short actigraphy-based sleep. CONCLUSIONS These findings suggest that orexin-mediated mechanisms play a role in the effects of methamphetamine on actigraphy-based sleep in female monkeys. Targeting the orexin system, in particular OX2 receptors, could be an effective option for treating sleep disruptions observed in individuals with methamphetamine use disorder.
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Affiliation(s)
- Daniel A Borgatti
- Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, Jackson, MS 39216, USA; Graduate Program in Neuroscience, University of Mississippi Medical Center, Jackson, MS 39216, USA
| | - James K Rowlett
- Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, Jackson, MS 39216, USA; Graduate Program in Neuroscience, University of Mississippi Medical Center, Jackson, MS 39216, USA; Center for Innovation and Discovery in Addictions, University of Mississippi Medical Center, Jackson, MS 39216, USA
| | - Lais F Berro
- Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, Jackson, MS 39216, USA; Graduate Program in Neuroscience, University of Mississippi Medical Center, Jackson, MS 39216, USA; Center for Innovation and Discovery in Addictions, University of Mississippi Medical Center, Jackson, MS 39216, USA.
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Yeh YH, Zheng MH, Tegge AN, Athamneh LN, Freitas-Lemos R, Dwyer CL, Bickel WK. The phenotype of recovery XI: associations of sleep quality and perceived stress with discounting and quality of life in substance use recovery. Qual Life Res 2024; 33:1621-1632. [PMID: 38504067 PMCID: PMC11116204 DOI: 10.1007/s11136-024-03625-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/29/2024] [Indexed: 03/21/2024]
Abstract
PURPOSE Sleep and stress show an interdependent relationship in physiology, and both are known risk factors for relapse in substance use disorder (SUD) recovery. However, sleep and stress are often investigated independently in addiction research. In this exploratory study, the associations of sleep quality and perceived stress with delay discounting (DD), effort discounting (ED), and quality of life (QOL) were examined concomitantly to determine their role in addiction recovery. DD has been proposed as a prognostic indicator of SUD treatment response, ED is hypothesized to be relevant to the effort to overcome addiction, and QOL is an important component in addiction recovery. METHOD An online sample of 118 individuals recovering from SUDs was collected through the International Quit and Recovery Registry. Exhaustive model selection, using the Bayesian Information Criterion to determine the optimal multiple linear model, was conducted to identify variables (i.e., sleep quality, perceived stress, and demographics) contributing to the total variance in DD, ED, and QOL. RESULTS After model selection, sleep was found to be significantly associated with DD. Stress was found to be significantly associated with psychological health, social relationships, and environment QOL. Both sleep and stress were found to be significantly associated with physical health QOL. Neither sleep nor stress was supported as an explanatory variable of ED. CONCLUSION Together, these findings suggest sleep and stress contribute uniquely to the process of addiction recovery. Considering both factors when designing interventions and planning for future research is recommended.
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Affiliation(s)
| | - Michelle H Zheng
- Civil and Environmental Engineering Department, University of California, Los Angeles, CA, USA
| | - Allison N Tegge
- Fralin Biomedical Research Institute at VTC, Roanoke, VA, USA
- Department of Statistics, Virginia Tech, Blacksburg, VA, USA
| | - Liqa N Athamneh
- Fralin Biomedical Research Institute at VTC, Roanoke, VA, USA
| | | | - Candice L Dwyer
- Fralin Biomedical Research Institute at VTC, Roanoke, VA, USA
- Department of Psychology, Virginia Tech, Blacksburg, VA, USA
| | - Warren K Bickel
- Fralin Biomedical Research Institute at VTC, Roanoke, VA, USA.
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Sohrabpour M, Kamyab A, Yari A, Harsini PA, Khani Jeihooni A. The factors affecting substance abuse relapse based on theory of planned behavior in male addicts covered by addiction treatment centers in Southern Iran. BMC Public Health 2024; 24:1265. [PMID: 38720295 PMCID: PMC11080208 DOI: 10.1186/s12889-024-18733-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2023] [Accepted: 04/29/2024] [Indexed: 05/12/2024] Open
Abstract
BACKGROUND Given the destructive nature of addiction and its relapse after quitting, the present study aimed to investigate the factors affecting substance abuse relapse based on the Theory of Planned Behavior (TPB) in male addicts covered by addiction treatment centers in Shiraz, Iran. METHODS This cross-sectional study was conducted on 400 male addicts covered by addiction treatment centers in Shiraz, Iran, in 2021-2022. The data collection tool was a researcher-made questionnaire. Data were analyzed using SPSS-22 software through descriptive statistical methods, linear regression, and binary logistic regression. RESULTS 190 people (47.50%) were aged 31-40 years, 265 people (66.25%) were married, 224 people (56%) lived with their spouses, and 192 people (48 percent) had their first use at the age of 16-20. The substance respondents used were methamphetamine (59.5%), heroin (53%), opium (48%), and alcohol (40%). 138 people (34.5%) had their first place of consumption at friends' houses (Tables 1 and 2). 342 people (85.5%) had a history of relapse, and 172 people (50.29%) had 1-5 relapses. Marital status, occupation, and income were among the demographic risk factors, and addicted friends and close relatives were among the behavioral risk factors for drug relapse among people with a history of relapse. Personal desire and the insistence of friends were also among the individual and interpersonal factors of drug use among participants. The regression results showed that the constructs of awareness, attitude, subjective norms, perceived behavioral control, and behavioral intention were predictors of drug relapse among addicts (P < 0.05). CONCLUSION The current study's findings indicate that among the behavioral risk factors for drug relapse in individuals with a history of relapse are addicted friends and close relatives, while marital status, occupation, and income are among the demographic risk variables. Among the individual and interpersonal factors influencing drug usage among participants were personal desire and friends' insistence. Furthermore, the findings indicated that the TPB's structures might be used to predict drug relapse in addicts.
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Affiliation(s)
- Mojtaba Sohrabpour
- Noncommunicable Diseases Research Center, Fasa University of Medical Sciences, Fasa, Iran
| | | | - Asiyeh Yari
- Department of Health Education and Health Promotion, School of Health, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Pooyan Afzali Harsini
- Department of Public Health, School of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Ali Khani Jeihooni
- Nutrition Research Center, Department of Public Health, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran.
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Tisdale RK, Sun Y, Park S, Ma SC, Haire M, Allocca G, Bruchas MR, Morairty SR, Kilduff TS. Biological sex influences sleep phenotype in mice experiencing spontaneous opioid withdrawal. J Sleep Res 2024; 33:e14037. [PMID: 37731248 PMCID: PMC10950840 DOI: 10.1111/jsr.14037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 08/16/2023] [Accepted: 08/17/2023] [Indexed: 09/22/2023]
Abstract
Aversive symptoms, including insomnia experienced during opioid withdrawal, are a major drive to relapse; however, withdrawal-associated sleep symptomatology has been little explored in preclinical models. We describe here a model of opioid withdrawal in mice that resembles the sleep phenotype characteristic of withdrawal in humans. Male and female C57BL/6 mice were instrumented with telemeters to record electroencephalogram, electromyogram, activity and subcutaneous temperature. All mice received two treatments separated by a 16-day washout period: (1) saline (volume: 10 ml kg-1); or (2) ascending doses of morphine (5, 10, 20, 40 and 80 mg kg-1; volume: 10 ml kg-1) for 5 days at Zeitgeber time 1 and Zeitgeber time 13. Recordings for the first 71 hr after treatment discontinuation (withdrawal days 1-3) and for 24 hr on withdrawal days 5 and 7 were scored for sleep/wake state, and sleep architecture and electroencephalogram spectral data were analysed. Morphine was acutely wake- and activity-promoting, and non-rapid eye movement and rapid eye movement sleep were increased during the dark phase on withdrawal day 2 in both sexes. While non-rapid eye movement delta power (0.5-4.0 Hz), a measure of sleep intensity, was reduced during the light phase on withdrawal day 1 and the dark phase on withdrawal day 2 in both sexes, female mice also exhibited changes in the duration and the number of bouts of sleep/wake states. These observations of fragmented sleep on withdrawal days 1-3 suggest poorer sleep consolidation and a more pronounced withdrawal-associated sleep phenotype in female than in male mice. These data may indicate a greater sensitivity to morphine, a more distinct aversive sleep phenotype and/or a faster escalation to dependence in female mice.
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Affiliation(s)
- Ryan K. Tisdale
- Center for Neuroscience, Biosciences Division, SRI International, Menlo Park, CA 94025
| | - Yu Sun
- Center for Neuroscience, Biosciences Division, SRI International, Menlo Park, CA 94025
| | - Sunmee Park
- Center for Neuroscience, Biosciences Division, SRI International, Menlo Park, CA 94025
| | - Shun-Chieh Ma
- Center for Neuroscience, Biosciences Division, SRI International, Menlo Park, CA 94025
| | - Meghan Haire
- Center for Neuroscience, Biosciences Division, SRI International, Menlo Park, CA 94025
| | | | - Michael R. Bruchas
- Center for Neurobiology of Addiction, Pain, and Emotion, Dept. of Anesthesiology and Pain Medicine, Univ. of Washington, Seattle, WA 98195
| | - Stephen R. Morairty
- Center for Neuroscience, Biosciences Division, SRI International, Menlo Park, CA 94025
| | - Thomas S. Kilduff
- Center for Neuroscience, Biosciences Division, SRI International, Menlo Park, CA 94025
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Deng Z, Liu L, Liu W, Liu R, Ma T, Xin Y, Xie Y, Zhang Y, Zhou Y, Tang Y. Alterations in the fecal microbiota of methamphetamine users with bad sleep quality during abstinence. BMC Psychiatry 2024; 24:324. [PMID: 38664669 PMCID: PMC11046801 DOI: 10.1186/s12888-024-05773-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Accepted: 04/17/2024] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND Methamphetamine (MA) abuse has resulted in a plethora of social issues. Sleep disturbance is a prominent issue about MA addiction, which serve as a risk factor for relapse, and the gut microbiota could play an important role in the pathophysiological mechanisms of sleep disturbances. Therefore, improving sleep quality can be beneficial for treating methamphetamine addiction, and interventions addressing the gut microbiota may represent a promising approach. METHOD We recruited 70 MA users to investigate the associations between sleep quality and fecal microbiota by the Pittsburgh Sleep Quality Index (PSQI), which was divided into MA-GS (PSQI score < 7, MA users with good sleep quality, n = 49) and MA-BS group (PSQI score ≥ 7, MA users with bad sleep quality, n = 21). In addition, we compared the gut microbiota between the MA-GS and healthy control (HC, n = 38) groups. 16S rRNA sequencing was applied to identify the gut bacteria. RESULT The study revealed that the relative abundances of the Thermoanaerobacterales at the order level differed between the MA-GS and MA-BS groups. Additionally, a positive correlation was found between the relative abundance of the genus Sutterella and daytime dysfunction. Furthermore, comparisons between MA users and HCs revealed differences in beta diversity and relative abundances of various bacterial taxa. CONCLUSION In conclusion, the study investigated alterations in the gut microbiota among MA users. Furthermore, we demonstrated that the genus Sutterella changes may be associated with daytime dysfunction, suggesting that the genus Sutterella may be a biomarker for bad sleep quality in MA users.
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Affiliation(s)
- Zijing Deng
- Brain Function Research Section, The First Hospital of China Medical University, Shenyang, 110001, Liaoning, PR China
- Department of Psychiatry, The First Hospital of China Medical University, Shenyang, 110001, Liaoning, PR China
| | - Linzi Liu
- Brain Function Research Section, The First Hospital of China Medical University, Shenyang, 110001, Liaoning, PR China
- Department of Psychiatry, The First Hospital of China Medical University, Shenyang, 110001, Liaoning, PR China
| | - Wen Liu
- Brain Function Research Section, The First Hospital of China Medical University, Shenyang, 110001, Liaoning, PR China
- Department of Psychiatry, The First Hospital of China Medical University, Shenyang, 110001, Liaoning, PR China
| | - Ruina Liu
- Department of Psychiatry, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, Shanxi, PR China
| | - Tao Ma
- Brain Function Research Section, The First Hospital of China Medical University, Shenyang, 110001, Liaoning, PR China
- Department of Psychiatry, The First Hospital of China Medical University, Shenyang, 110001, Liaoning, PR China
| | - Yide Xin
- Brain Function Research Section, The First Hospital of China Medical University, Shenyang, 110001, Liaoning, PR China
| | - Yu Xie
- Brain Function Research Section, The First Hospital of China Medical University, Shenyang, 110001, Liaoning, PR China
| | - Yifan Zhang
- Brain Function Research Section, The First Hospital of China Medical University, Shenyang, 110001, Liaoning, PR China
- Department of Psychiatry, The First Hospital of China Medical University, Shenyang, 110001, Liaoning, PR China
| | - Yifang Zhou
- Brain Function Research Section, The First Hospital of China Medical University, Shenyang, 110001, Liaoning, PR China
- Department of Psychiatry, The First Hospital of China Medical University, Shenyang, 110001, Liaoning, PR China
| | - Yanqing Tang
- Department of Psychiatry, Shengjing Hospital of China Medical University, Shenyang, 110004, Liaoning, PR China.
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Al-Ziadat MA. Do social support and self- efficacy play a significant role in substance use relapse? Health Psychol Res 2024; 12:94576. [PMID: 38533344 PMCID: PMC10963257 DOI: 10.52965/001c.94576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Accepted: 02/05/2024] [Indexed: 03/28/2024] Open
Abstract
This study aims to investigate if social support and self-efficacy play a significant role in substance use relapse. To this end, 197 substance users responded to the modified measures of social support and self-efficacy questionnaire. The participants reported moderate levels of social support and self-efficacy. In addition, the results indicated that there are gender differences in social support level in favour of males and there were differences in social support level in the duration of substance use between less than one year and one year- less than two years also between one year- less than two years and ten years and more in favour of one year- less than two years. Furthermore, the results revealed differences in self-efficacy levels in accordance with substance use status in favour of those without relapse. But there was no difference in self-efficacy level with regard to gender or duration of substance use. Moreover, the findings indicate that self-efficacy and duration of substance use play a significant role in substance use relapse but this is not the case with social support. It was concluded that giving more attention to female social support and to the self-efficacy among substance users are needed.
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Acheson LS, Gordon C, McKetin R, Brett J, Christmass M, Rodgers C, Lintzeris N, Dunlop A, Farrell M, Shoptaw S, Ezard N, Siefried KJ. Measuring Objective and Subjective Sleep during Lisdexamfetamine Treatment of Acute Methamphetamine Withdrawal: A Feasibility Study. Eur Addict Res 2024; 30:121-125. [PMID: 38498995 DOI: 10.1159/000536328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 12/21/2023] [Indexed: 03/20/2024]
Abstract
INTRODUCTION Sleep disturbance is common during methamphetamine (MA) use and withdrawal; however, the feasibility of combined subjective-objective measurement of sleep-wake has not been shown in this population. Actigraphy is a well-established, non-invasive measure of sleep-wake cycles with good concordance with polysomnography. This study aimed to investigate the feasibility and utility of using actigraphy and sleep diaries to investigate sleep during MA withdrawal. METHODS We conducted a feasibility and utility study of actigraphy and sleep diaries during a clinical trial of lisdexamfetamine for MA withdrawal. Participants were inpatients for 7 days, wore an actigraph (Philips Actiwatch 2) and completed a modified Consensus Sleep Diary each morning. Participants were interviewed between days 3-5. RESULTS Ten participants (mean age 37 years, 90% male) were enrolled. No participant removed the device prematurely. Participants interviewed (n = 8) reported that the actigraph was not difficult or distracting to wear or completion of daily sleep diary onerous. Actigraphic average daily sleep duration over 7 days was 568 min, sleep onset latency 22.4 min, wake after sleep onset (WASO) 75.2 min, and sleep efficiency 83.6%. Sleep diaries underreported daily sleep compared with actigraphy (sleep duration was 56 min (p = 0.008) and WASO 47 min (p < 0.001) less). Overall sleep quality was 4.4 on a nine-point Likert scale within the diary. CONCLUSIONS Continuous actigraphy is feasible to measure sleep-wake in people withdrawing from MA, with low participant burden. We found important differences in self-reported and actigraphic sleep, which need to be explored in more detail.
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Affiliation(s)
- Liam S Acheson
- The National Drug and Alcohol Research Centre (NDARC), The University of New South Wales, Sydney, New South Wales, Australia
- Alcohol and Drug Service, St Vincent's Hospital Sydney, Sydney, New South Wales, Australia
- The National Centre for Clinical Research on Emerging Drugs (NCCRED), c/o the University of New South Wales, Sydney, New South Wales, Australia
| | - Christopher Gordon
- Susan Wakil School of Nursing and Midwifery, The University of Sydney, Sydney, New South Wales, Australia
- CIRUS Centre for Sleep and Chronobiology, Woolcock Institute of Medical Research, University of Sydney, Sydney, New South Wales, Australia
| | - Rebecca McKetin
- The National Drug and Alcohol Research Centre (NDARC), The University of New South Wales, Sydney, New South Wales, Australia
| | - Jonathan Brett
- Clinical Pharmacology and Toxicology, St Vincent's Hospital Sydney, Sydney, New South Wales, Australia
- St. Vincent's Clinical School, The University of New South Wales, Sydney, New South Wales, Australia
| | - Michael Christmass
- Next Step Drug and Alcohol Services, Perth, Washington, Australia
- National Drug Research Institute, Curtin University, Perth, Washington, Australia
| | - Craig Rodgers
- Alcohol and Drug Service, St Vincent's Hospital Sydney, Sydney, New South Wales, Australia
| | - Nicholas Lintzeris
- New South Wales Drug and Alcohol Clinical Research and Improvement Network (DACRIN), Sydney, New South Wales, Australia
- Drug and Alcohol Services, Sydney, New South Wales, Australia
- Specialty of Addiction Medicine, The University of Sydney, Sydney, New South Wales, Australia
| | - Adrian Dunlop
- New South Wales Drug and Alcohol Clinical Research and Improvement Network (DACRIN), Sydney, New South Wales, Australia
- Drug and Alcohol Clinical Services, Newcastle, New South Wales, Australia
- School of Medicine and Public Health, The University of Newcastle, Newcastle, New South Wales, Australia
| | - Michael Farrell
- The National Drug and Alcohol Research Centre (NDARC), The University of New South Wales, Sydney, New South Wales, Australia
| | - Steven Shoptaw
- Department of Family Medicine, The University of California Los Angeles, Los Angeles, California, USA
| | - Nadine Ezard
- Alcohol and Drug Service, St Vincent's Hospital Sydney, Sydney, New South Wales, Australia
- The National Centre for Clinical Research on Emerging Drugs (NCCRED), c/o the University of New South Wales, Sydney, New South Wales, Australia
- New South Wales Drug and Alcohol Clinical Research and Improvement Network (DACRIN), Sydney, New South Wales, Australia
| | - Krista J Siefried
- The National Drug and Alcohol Research Centre (NDARC), The University of New South Wales, Sydney, New South Wales, Australia
- Alcohol and Drug Service, St Vincent's Hospital Sydney, Sydney, New South Wales, Australia
- The National Centre for Clinical Research on Emerging Drugs (NCCRED), c/o the University of New South Wales, Sydney, New South Wales, Australia
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12
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Pitrat B, Turpin A, Peyret E, Hamonniere T, Drain A, Maatoug R, Le Roux E. Mobile app measuring sleep and behaviors: A trial in adolescents with addiction. L'ENCEPHALE 2024:S0013-7006(23)00214-2. [PMID: 38311486 DOI: 10.1016/j.encep.2023.11.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 10/08/2023] [Accepted: 11/02/2023] [Indexed: 02/06/2024]
Abstract
INTRODUCTION The smartphones generalisation allows the development of attractive "real-life" monitoring tools for care and research enabling the measurement of addictive behaviours and comorbidities such as sleep disorders. The study objective was to assess the interest of a mobile app collecting such information among adolescents with addictive behaviours in order to enhance the availability of behavioural data in consultation. METHODS An open label randomised pilot study was held along two parallel arms. The patients randomised to the intervention group (n=18) used a mobile app to provide daily data for 15 days relating to their sleep and their behaviour (addictive behaviours with or without substances). The patients in the control group (n=18) used a paper diary allowing the collection of the same data, only the medium differed. RESULTS The patients' median age was 16 years [15.0-16.5]. A median of 67% and 10% of the expected information was completed respectively in the intervention and control groups during the 15 days of follow-up and could be used in consultation (P=0.08). The patient's knowledge, attitudes, intentions to change, behaviour change and seeking help related to the use of the diaries appeared higher in the intervention group (20.5/30) than in the control group (11/20). CONCLUSION This study described the high patient compliance with the data collection by means of the app. The diary app seems to have been more impactful for patients than the paper diary. This app could represent an important tool to improve the therapeutic alliance and care due to a better knowledge of the behaviours on the part of the clinician but also a better awareness of the patients themselves.
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Affiliation(s)
- Benjamin Pitrat
- Child and Adolescent Psychiatry Department, Robert-Debré Hospital, AP-HP Nord-université de Paris, 75019 Paris, France
| | - Agathe Turpin
- Clinical Epidemiology Unit, Robert-Debré Hospital, AP-HP Nord-université de Paris, Inserm, CIC 1426, Paris, France
| | - Emmanuelle Peyret
- Child and Adolescent Psychiatry Department, Robert-Debré Hospital, AP-HP Nord-université de Paris, 75019 Paris, France
| | - Tristan Hamonniere
- LPPS, université de Paris, 92100 Boulogne-Billancourt, France; Clinique médicale et pédagogique Dupré, Fondation santé des étudiants de France, Sceaux, France
| | | | - Redwan Maatoug
- Service de psychiatrie adulte de la Pitié-Salpêtrière, institut du cerveau (ICM), AP-HP, Sorbonne université, 75013 Paris, France
| | - Enora Le Roux
- Clinical Epidemiology Unit, Robert-Debré Hospital, AP-HP Nord-université de Paris, Inserm, CIC 1426, Paris, France; ECEVE UMR 1123, Inserm, université de Paris, Paris, France.
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13
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Baskerville WA, Grodin EN, Ray LA. Influence of sleep quality on lapse to alcohol use during a quit attempt. Alcohol Alcohol 2024; 59:agae009. [PMID: 38366914 PMCID: PMC10873907 DOI: 10.1093/alcalc/agae009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Revised: 11/27/2023] [Accepted: 12/16/2023] [Indexed: 02/19/2024] Open
Abstract
AIMS Sleep problems are common among individuals with alcohol use disorder (AUD) and is often associated with a heightened relapse risk. The present study examines the relationship between sleep and alcohol use among individuals with current AUD during a 6-day quit attempt as part of a medication study. METHODS The current study is a secondary analysis of a medication trial for individuals with AUD. Individuals with AUD (N = 53, 26 females) were randomized to active medication or matched placebo. Randomized participants completed a week-long medication titration (Days 1-7). Following the titration period, participants attended an in-person visit (Day 8) to begin a 6-day quit attempt. During the quit attempt, participants completed daily diary assessments to report on previous day alcohol consumption, sleep quality, and alcohol craving. In the present study, medication condition was controlled for in all models. RESULTS Baseline global sleep quality was not a significant predictor of drinks per drinking day (P = 0.72) or percent days abstinent (P = 0.16) during the 6-day practice quit attempt. Daily diary analyses found that greater sleep quality was associated with higher next-day drinks per drinking day (b = 0.198, P = 0.029). In contrast, participants reported worse sleep quality following nights of greater alcohol intake, albeit at a trend-level (b = -0.12, P = 0.053). CONCLUSIONS These results suggest that better sleep quality was a risk factor for drinking during the 6-day quit period, such that better sleep may be associated with increased craving for alcohol and alcohol use the next day. These findings are limited to the early abstinence period and should be considered in studies exploring longer periods of abstinence.
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Affiliation(s)
- Wave-Ananda Baskerville
- Department of Psychology, University of California, Los Angeles, 1285 Franz Hall, Box 51563, Los Angeles, CA 90095-1563, United States
| | - Erica N Grodin
- Department of Psychology, University of California, Los Angeles, 1285 Franz Hall, Box 51563, Los Angeles, CA 90095-1563, United States
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, 757 Westwood Plaza #4, Los Angeles, CA 90095, United States
| | - Lara A Ray
- Department of Psychology, University of California, Los Angeles, 1285 Franz Hall, Box 51563, Los Angeles, CA 90095-1563, United States
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, 757 Westwood Plaza #4, Los Angeles, CA 90095, United States
- Brain Research Institute, University of California, Los Angeles, 695 Charles E Young Dr. S, Los Angeles, CA 90095, United States
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14
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Miller MB, Carpenter RW, Freeman LK, Dunsiger S, McGeary JE, Borsari B, McCrae CS, Arnedt JT, Korte P, Merrill JE, Carey KB, Metrik J. Effect of Cognitive Behavioral Therapy for Insomnia on Alcohol Treatment Outcomes Among US Veterans: A Randomized Clinical Trial. JAMA Psychiatry 2023; 80:905-913. [PMID: 37342036 PMCID: PMC10285676 DOI: 10.1001/jamapsychiatry.2023.1971] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 04/06/2023] [Indexed: 06/22/2023]
Abstract
Importance Three of 4 adults in treatment for alcohol use disorder (AUD) report symptoms of insomnia. Yet the first-line treatment for insomnia (cognitive behavioral therapy for insomnia, CBT-I) is often delayed until abstinence is established. Objective To test the feasibility, acceptability, and preliminary efficacy of CBT-I among veterans early in their AUD treatment and to examine improvement in insomnia as a mechanism for improvement in alcohol use outcomes. Design, Setting, and Participants For this randomized clinical trial, participants were recruited through the Addictions Treatment Program at a Veterans Health Administration hospital between 2019 and 2022. Patients in treatment for AUD were eligible if they met criteria for insomnia disorder and reported alcohol use in the past 2 months at baseline. Follow-up visits occurred posttreatment and at 6 weeks. Interventions Participants were randomly assigned to receive 5 weekly sessions of CBT-I or a single session about sleep hygiene (control). Participants were asked to complete sleep diaries for 7 days at each assessment. Main Outcomes and Measures Primary outcomes included posttreatment insomnia severity (assessed using the Insomnia Severity Index) and follow-up frequency of any drinking and heavy drinking (4 drinks for women, ≥5 drinks for men; number of days via Timeline Followback) and alcohol-related problems (Short Inventory of Problems). Posttreatment insomnia severity was tested as a mediator of CBT-I effects on alcohol use outcomes at the 6-week follow-up. Results The study cohort included 67 veterans with a mean (SD) age of 46.3 years (11.8); 61 (91%) were male and 6 (9%) female. The CBT-I group included 32 participants, and the sleep hygiene control group 35 participants. Of those randomized, 59 (88%) provided posttreatment or follow-up data (31 CBT-I, 28 sleep hygiene). Relative to sleep hygiene, CBT-I participants reported greater decreases in insomnia severity at posttreatment (group × time interaction: -3.70; 95% CI, -6.79 to -0.61) and follow-up (-3.34; 95% CI, -6.46 to -0.23) and greater improvements in sleep efficiency (posttreatment, 8.31; 95% CI, 1.35 to 15.26; follow-up, 18.03; 95% CI, 10.46 to 25.60). They also reported greater decreases in alcohol problems at follow-up (group × time interaction: -0.84; 95% CI, -1.66 to -0.02), and this effect was mediated by posttreatment change in insomnia severity. No group differences emerged for abstinence or heavy-drinking frequency. Conclusions and Relevance In this randomized clinical trial, CBT-I outperformed sleep hygiene in reducing insomnia symptoms and alcohol-related problems over time but had no effect on frequency of heavy drinking. CBT-I should be considered a first-line treatment for insomnia, regardless of abstinence. Trial Registration ClinicalTrials.gov Identifier: NCT03806491.
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Affiliation(s)
| | | | | | - Shira Dunsiger
- Brown University School of Public Health, Providence, Rhode Island
| | - John E. McGeary
- Brown University School of Public Health, Providence, Rhode Island
- Providence VA Medical Center, Providence, Rhode Island
| | - Brian Borsari
- San Francisco VA Health Care System, San Francisco, California
- University of California, San Francisco
| | | | | | - Paul Korte
- Harry S. Truman Memorial Veterans’ Hospital, Columbia, Missouri
| | | | - Kate B. Carey
- Brown University School of Public Health, Providence, Rhode Island
| | - Jane Metrik
- Brown University School of Public Health, Providence, Rhode Island
- Providence VA Medical Center, Providence, Rhode Island
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15
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Mazzitelli M, Trunfio M, Milinkovic A, Castelli E, Sasset L, Leoni D, Salvucci M, Cazzaro R, Calcinoni I, Balducci P, Ribeiro GCQ, Filagrana G, Scaglione V, Cattelan AM. Sleep disturbances and their correlation with cardiovascular risk, obesity, and mood disorders in people with HIV. AIDS 2023; 37:925-934. [PMID: 36723511 DOI: 10.1097/qad.0000000000003493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
BACKGROUND The relationship between sleep disorders (SDs), cardiovascular risk (CVR), and mood disorders (MDs) has been studied in detail in the general population, but far less in people with HIV (PWH). METHODS Cross-sectional analysis in single centre cohort of PWH. Sleep quality was assessed using by Epworth Sleepiness Scale (ESS), Insomnia Severity Index (ISI), Berlin Questionnaire (BQ), Pittsburgh Sleep Quality Index (PSQI); anxiety and depression were evaluated by the Generalized Anxiety Disorder-7 and Patient Health Questionnaire-9. Demographic, clinical and HIV-related data were collected, and Framingham and Data collection on Adverse effects of anti-HIV Drugs (DAD)-10 scores were computed in modelling associations with each SDs scale. RESULTS Data were collected for 721 PWH on stable combination antiretroviral therapy (cART) (median age of 53 years, 71.8% males, 96% with undetectable HIV RNA, 50.3% on cART potentially affecting sleep, and 20.4% on hypno-inducing drugs), 76.9% had SDs 60.3, 31.3, 31.1, and 7.9% at PSQI, BQ, ISI, and ESS, respectively. Anxiety and depression were detected in 28.3 and 16.1% participants, respectively. BQ score was independently associated with high BMI ( P < 0.001), Framingham risk >10% ( P < 0.001), and both DAD-10R and -10F score >10% ( P < 0.001 and P = 0.031). PSQI and ISI scores were independently associated with depression and anxiety ( P < 0.001). No association between SDs and specific antiretroviral regimens, nor HIV-related parameters was detected. CONCLUSIONS In our cohort of PWH on stable ART, despite the alarmingly higher prevalence, SDs were associated with the same determinants (cardiovascular risk factors and MDs) observed in the general population.
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Affiliation(s)
- Maria Mazzitelli
- Department of Molecular Medicine, Infectious and Tropical Diseases Unit, Department of Medical Sciences, Padua University Hospital, Padua
| | - Mattia Trunfio
- Infectious Diseases Unit, Department of Medical Sciences, University of Turin at Amedeo di Savoia Hospital, Turin, Italy
- HIV Neurobehavioral Research Program and Departments of Neurosciences and Psychiatry, School of Medicine, University of California, San Diego, California, USA
| | - Ana Milinkovic
- Chelsea and Westminster Foundation Trust
- Imperial College London, London, UK
| | - Eleonora Castelli
- Department of Molecular Medicine, Infectious and Tropical Diseases Unit, Department of Medical Sciences, Padua University Hospital, Padua
| | - Lolita Sasset
- Department of Molecular Medicine, Infectious and Tropical Diseases Unit, Department of Medical Sciences, Padua University Hospital, Padua
| | - Davide Leoni
- Department of Molecular Medicine, Infectious and Tropical Diseases Unit, Department of Medical Sciences, Padua University Hospital, Padua
| | | | | | | | | | | | | | - Vincenzo Scaglione
- Department of Molecular Medicine, Infectious and Tropical Diseases Unit, Department of Medical Sciences, Padua University Hospital, Padua
| | - Anna M Cattelan
- Department of Molecular Medicine, Infectious and Tropical Diseases Unit, Department of Medical Sciences, Padua University Hospital, Padua
- Student at University of Padua, Padua University Hospital
- University of Padua, Padua, Italy
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16
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Nowakowska-Domagała K, Podlecka M, Stecz P, Lewandowska A, Sipowicz K, Kosmalski M, Pietras T, Mokros Ł. The Relationship between Selected Factors (Temperament, Bipolar Traits, Sleep Quality, Severity of Addiction) and Depressive Symptoms in Alcohol-Dependent Men. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4072. [PMID: 36901082 PMCID: PMC10001749 DOI: 10.3390/ijerph20054072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 02/11/2023] [Accepted: 02/22/2023] [Indexed: 06/18/2023]
Abstract
Clinical and epidemiological studies have demonstrated a relationship between alcohol addiction and mood disorders. Alcohol-dependent patients with depression tend to demonstrate clinically more severe manic symptoms, which complicates the process of diagnosis and therapy. However, the predictors indicating the risk of mood disorders in addicted patients remain unclear. The aim of the study was to examine the relationship between personal dispositions, bipolar traits, depth of addiction, quality of sleep, and depressive symptoms in alcohol-dependent men. The study group comprised 70 men (age M = 46.06, SD = 11.29) diagnosed with alcohol addiction. The participants completed a battery of questionnaires: BDI, HCL-32, PSQI, EPQ-R and MAST. The results were tested using Pearson's correlation quotient and general linear model. The findings indicate that some of the studied patients are likely to have mood disorders of clinically significant severity. High neuroticism and poor sleep quality are independent predictors of depressive symptoms in alcohol-dependent patients. Among the components of sleep quality, problems with falling asleep and waking up at night appear to be most strongly associated with depressive symptoms. The intensity of depressive symptoms may relate to the intensity of certain bipolar features, such as risk-taking activity and irritability. High neuroticism and poor sleep quality are independent predictors of depressive symptoms in the studied group.
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Affiliation(s)
- Katarzyna Nowakowska-Domagała
- Institute of Psychology, Faculty of Educational Sciences, University of Lodz, Al. Rodzeństwa Scheiblerów 2, 90-128 Lodz, Poland
| | - Marlena Podlecka
- Institute of Psychiatry and Neurology, Department of Neurosis, Personality and Eating Disorders, Sobieskiego Street 9, 02-957 Warsaw, Poland
| | - Patryk Stecz
- Institute of Psychology, Faculty of Educational Sciences, University of Lodz, Al. Rodzeństwa Scheiblerów 2, 90-128 Lodz, Poland
| | - Aleksandra Lewandowska
- J. Babiński Specialist Psychiatric Health Care Team, Psychiatric Ward for Children, Aleksandrowska 159, 02-229 Lodz, Poland
| | - Kasper Sipowicz
- Department of Interdisciplinary Disability Studies, The Maria Grzegorzewska University in Warsaw, Szczęśliwicka 40, 02-353 Warsaw, Poland
| | - Marcin Kosmalski
- Department of Clinical Pharmacology, Medical University of Lodz, Kopcinskiego Street 22, 90-153 Lodz, Poland
| | - Tadeusz Pietras
- Institute of Psychiatry and Neurology, Second Department of Psychiatry, Sobieskiego Street 9, 02-957 Warsaw, Poland
| | - Łukasz Mokros
- Department of Clinical Pharmacology, Medical University of Lodz, Kopcinskiego Street 22, 90-153 Lodz, Poland
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17
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Kavaliotis E, Boardman JM, Clark JW, Ogeil RP, Verdejo-García A, Drummond SPA. The relationship between sleep and appetitive conditioning: A systematic review and meta-analysis. Neurosci Biobehav Rev 2023; 144:105001. [PMID: 36529310 DOI: 10.1016/j.neubiorev.2022.105001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 11/24/2022] [Accepted: 12/12/2022] [Indexed: 12/23/2022]
Abstract
This systematic review and meta-analysis (PROSPERO registration animal/human studies: CRD42021234793/CRD42021234790) examined the relationship between sleep and appetitive conditioning. Inclusion criteria included: a) appetitive conditioning paradigm; b) measure of conditioning; c) sleep measurement and/or sleep loss; d) human and/etor non-human animal samples; and e) written in English. Searches of seven databases returned 3777 publications. The final sample consisted of 42 studies using primarily animal samples and involving food- and drug-related conditioning tasks. We found sleep loss disrupted appetitive conditioning of food rewards (p < 0.001) but potentiated appetitive conditioning of drug rewards (p < 0.001). Furthermore, sleep loss negatively impacted extinction learning irrespective of the reward type. Post-learning sleep was associated with increases in REM sleep (p = 0.02). Findings suggest sleep loss potentiates the impact of psychoactive substances in a manner likely to produce an increased risk of problematic substance use. In obese/overweight populations, sleep loss may be associated with deficits in the conditioning and extinction of reward-related behaviours. Further research should assess the relationship between sleep and appetitive conditioning in humans.
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Affiliation(s)
- Eleni Kavaliotis
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Victoria 3800, Australia
| | - Johanna M Boardman
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Victoria 3800, Australia
| | - Jacob W Clark
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Victoria 3800, Australia
| | - Rowan P Ogeil
- Eastern Health Clinical School and Monash Addiction Research Centre, Faculty of Medicine, Nursing and Health Sciences, Monash University, Victoria 3800, Australia; Turning Point, Eastern Health, Victoria 3121, Australia
| | - Antonio Verdejo-García
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Victoria 3800, Australia
| | - Sean P A Drummond
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Victoria 3800, Australia.
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18
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Guo R, Vaughan DT, Rojo ALA, Huang YH. Sleep-mediated regulation of reward circuits: implications in substance use disorders. Neuropsychopharmacology 2023; 48:61-78. [PMID: 35710601 PMCID: PMC9700806 DOI: 10.1038/s41386-022-01356-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 05/22/2022] [Accepted: 05/27/2022] [Indexed: 12/11/2022]
Abstract
Our modern society suffers from both pervasive sleep loss and substance abuse-what may be the indications for sleep on substance use disorders (SUDs), and could sleep contribute to the individual variations in SUDs? Decades of research in sleep as well as in motivated behaviors have laid the foundation for us to begin to answer these questions. This review is intended to critically summarize the circuit, cellular, and molecular mechanisms by which sleep influences reward function, and to reveal critical challenges for future studies. The review also suggests that improving sleep quality may serve as complementary therapeutics for treating SUDs, and that formulating sleep metrics may be useful for predicting individual susceptibility to SUDs and other reward-associated psychiatric diseases.
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Affiliation(s)
- Rong Guo
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, 15219, USA
- Allen Institute, Seattle, WA, 98109, USA
| | - Dylan Thomas Vaughan
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, 15219, USA
- The Center for Neuroscience at the University of Pittsburgh, Pittsburgh, PA, USA
| | - Ana Lourdes Almeida Rojo
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, 15219, USA
- The Center for Neuroscience at the University of Pittsburgh, Pittsburgh, PA, USA
| | - Yanhua H Huang
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, 15219, USA.
- The Center for Neuroscience at the University of Pittsburgh, Pittsburgh, PA, USA.
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19
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Juda M, Pater J, Mistlberger RE, Schütz CG. Sleep and Rest-Activity Rhythms in Recovering Patients with Severe Concurrent Mental and Substance Use Disorder: A Pilot Study. J Dual Diagn 2023; 19:26-39. [PMID: 36580397 DOI: 10.1080/15504263.2022.2157694] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Objective: Mental health and substance use disorders are commonly associated with disrupted sleep and circadian rest-activity rhythms. How these disorders in combination relate to sleep and circadian organization is not well studied. We provide here the first quantitative assessment of sleep and rest-activity rhythms in inpatients with complex concurrent disorders, taking into account categories of substance use (stimulant vs. stimulant and opioid use) and psychiatric diagnosis (psychotic disorder and mood disorder). We also explore how sleep and rest-activity rhythms relate to psychiatric functioning. Methods: A total of 44 participants (10 female) between the age of 20-60 years (median = 29 years) wore wrist accelerometers over 5-70 days and completed standardized questionnaires assessing chronotype and psychiatric functioning (fatigue, psychiatric symptom severity, and impulsiveness). To examine potential influences from treatment, we computed (1) length of stay; (2) days of abstinence from stimulants and opioids as a measure of withdrawal; and (3) a sedative load based on prescribed medications. Results: Participants exhibited a sustained excessive sleep duration, frequent nighttime awakenings, and advanced rest-activity phase related to sedative load. Sleep disruptions were elevated in participants with a history of opioid use. Patients with a psychotic disorder showed the longest sleep and most fragmented and irregular rest-activity patterns. Non-parametric circadian rhythm analysis revealed a high rhythm amplitude by comparison with population norms, and this was associated with greater psychiatric symptom severity. Psychiatric symptom severity was also associated with greater fatigue and later MCTQ chronotype. Conclusions: This pilot study provides initial information on the prevalence and severity of sleep and circadian rhythm disturbances in individuals with severe concurrent disorders. The results underline the need for further studies to start to understand the role of sleep in the disease and recovery process in this understudied population.
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Affiliation(s)
- Myriam Juda
- Sleep and Circadian Neuroscience Laboratory, Department of Psychology, Simon Fraser University, Burnaby, Canada.,Behavioral Reward Affect + Impulsivity Neuroscience (BRAIN) Lab, Department of Psychiatry, Institute of Mental Health, University of British Columbia, Vancouver, Canada.,Telfer School of Management, University of Ottawa, Ottawa, Canada
| | - Joanna Pater
- Sleep and Circadian Neuroscience Laboratory, Department of Psychology, Simon Fraser University, Burnaby, Canada.,Behavioral Reward Affect + Impulsivity Neuroscience (BRAIN) Lab, Department of Psychiatry, Institute of Mental Health, University of British Columbia, Vancouver, Canada.,School of Medicine, St. George's University, St. George's, Grenada
| | - Ralph E Mistlberger
- Sleep and Circadian Neuroscience Laboratory, Department of Psychology, Simon Fraser University, Burnaby, Canada
| | - Christian G Schütz
- Behavioral Reward Affect + Impulsivity Neuroscience (BRAIN) Lab, Department of Psychiatry, Institute of Mental Health, University of British Columbia, Vancouver, Canada.,Provincial Health Services Authority, Red Fish Healing Centre for Mental Health and Addiction, Coquitlam, Canada
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20
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Guo R, Wang Y, Yan R, Chen B, Ding W, Gorczyca MT, Ozsoy S, Cai L, Hines RL, Tseng GC, Allocca G, Dong Y, Fang J, Huang YH. Rapid Eye Movement Sleep Engages Melanin-Concentrating Hormone Neurons to Reduce Cocaine Seeking. Biol Psychiatry 2022; 92:880-894. [PMID: 35953320 PMCID: PMC9872495 DOI: 10.1016/j.biopsych.2022.06.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 06/03/2022] [Accepted: 06/06/2022] [Indexed: 01/27/2023]
Abstract
BACKGROUND Persistent sleep disruptions following withdrawal from abused drugs may hold keys to battle drug relapse. It is posited that there may be sleep signatures that predict relapse propensity, identifying which may open new avenues for treating substance use disorders. METHODS We trained male rats (approximately postnatal day 56) to self-administer cocaine. After long-term drug withdrawal (approximately postnatal day 100), we examined the correlations between the intensity of cocaine seeking and key sleep features. To test for causal relationships, we then used behavioral, chemogenetic, or optogenetic methods to selectively increase rapid eye movement sleep (REMS) and measured behavioral and electrophysiological outcomes to probe for cellular and circuit mechanisms underlying REMS-mediated regulation of cocaine seeking. RESULTS A selective set of REMS features was preferentially associated with the intensity of cue-induced cocaine seeking after drug withdrawal. Moreover, selectively increasing REMS time and continuity by environmental warming attenuated a withdrawal time-dependent intensification of cocaine seeking, or incubation of cocaine craving, suggesting that REMS may benefit withdrawal. Warming increased the activity of lateral hypothalamic melanin-concentrating hormone (MCH) neurons selectively during prolonged REMS episodes and counteracted cocaine-induced synaptic accumulation of calcium-permeable AMPA receptors in the nucleus accumbens-a critical substrate for incubation. Finally, the warming effects were partly mimicked by chemogenetic or optogenetic stimulations of MCH neurons during sleep, or intra-accumbens infusions of MCH peptide during the rat's inactive phase. CONCLUSIONS REMS may encode individual vulnerability to relapse, and MCH neuron activities can be selectively targeted during REMS to reduce drug relapse.
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Affiliation(s)
- Rong Guo
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Yao Wang
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Rongzhen Yan
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Bo Chen
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Wanqiao Ding
- Department of Neuroscience, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Michael T Gorczyca
- Department of Biostatistics, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Sahin Ozsoy
- Somnivore Pty. Ltd., Bacchus Marsh, Victoria, Australia
| | - Li Cai
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Rachel L Hines
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - George C Tseng
- Department of Biostatistics, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Giancarlo Allocca
- Somnivore Pty. Ltd., Bacchus Marsh, Victoria, Australia; Department of Pharmacology and Therapeutics, University of Melbourne, Parkville, Victoria, Australia; Florey Institute of Neuroscience and Mental Health, University of Melbourne, Parkville, Victoria, Australia
| | - Yan Dong
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania; Department of Neuroscience, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Jidong Fang
- Department of Psychiatry and Behavioral Health, Penn State College of Medicine, Hershey, Pennsylvania
| | - Yanhua H Huang
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania.
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21
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Speed TJ, Hanks L, Turner G, Gurule E, Kearson A, Buenaver L, Smith MT, Antoine D. A comparison of cognitive behavioral therapy for insomnia to standard of care in an outpatient substance use disorder clinic embedded within a therapeutic community: a RE-AIM framework evaluation. Trials 2022; 23:965. [DOI: 10.1186/s13063-022-06885-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 11/04/2022] [Indexed: 11/29/2022] Open
Abstract
Abstract
Background
Rates of substance use disorders (SUDs) continue to rise in the USA with parallel rises in admissions to outpatient SUD treatment programs. Insomnia symptoms reduce treatment adherence, trigger relapse, and generally undermine SUD recovery efforts. Cognitive-behavioral therapy for insomnia (CBT-I) is the first-line treatment recommended for chronic insomnia. No study has examined the effectiveness of CBT-I for individuals who recently entered an outpatient SUD treatment program embedded within a therapeutic community (i.e., long-term drug-free residential setting).
Methods
A randomized controlled trial conducted at a SUD program embedded in a therapeutic community aimed to compare group-based CBT-I (gCBT-I) (N = 10) with the standard of care (SOC) (N = 11) among individuals who have SUDs and comorbid insomnia. We present a RE-AIM (reach, effectiveness, adoption, implementation, and maintenance) framework evaluation to provide empirical data on gCBT-I feasibility and facilitators and barriers of conducting an insomnia-focused clinical effectiveness study within a therapeutic community.
Results
Participants in both study arms reported moderately severe insomnia symptoms at admission and reductions in insomnia symptoms over time. Among participants who completed the Insomnia Severity Index (ISI) beyond admission, ISI decreased to ≤ 8 (the clinical cutoff for mild insomnia) in 80% of individuals in the gCBT-I group compared with 25% of individuals in the SOC group. A RE-AIM framework evaluation showed initial success with Reach and Adoption while Implementation, and Maintenance were limited. Effectiveness was inconclusive because of challenges with recruitment, intervention integrity, and missing data that precluded meeting the planned recruitment and study aims and led to study termination. Coordination and communication with staff and leadership facilitated gCBT-I implementation, yet well-known CBT-I barriers including time- and resource-intensive sleep medicine training for interventionalists and maintenance of treatment integrity during an 8-week intervention limited gCBT-I sustainability.
Conclusions
This analysis supports the feasibility of conducting behavioral sleep medicine research in outpatient SUD treatment programs embedded within therapeutic communities. Implementation of an insomnia-focused intervention was widely accepted by patients and providers and has potential to address insomnia symptoms in early SUD recovery. Addressing patient- and organizational-level implementation barriers may enhance the sustainability and scalability of sleep interventions and provide new hope to effectively treat insomnia among people living with SUDs.
Trial registration
Clinicaltrials.gov: NCT03208855. Registered July 6, 2017https://clinicaltrials.gov/ct2/show/NCT03208855?term=NCT03208855&draw=2&rank=1
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22
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Sun Y, Wang L, Li C, Luo W. Sleep Disturbance in Chinese College Students with Mental Health Problems: A Moderated Mediation Model. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14570. [PMID: 36361449 PMCID: PMC9653838 DOI: 10.3390/ijerph192114570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 10/16/2022] [Accepted: 11/03/2022] [Indexed: 06/16/2023]
Abstract
Sleep disturbance has an enormous impact on college students. Poor sleep is associated with low academic achievement, psychological distress and high health risk behaviors. College students with various mental health problems (e.g., anxiety and depression) are particularly at risk for sleep problems. The aim of the present study was to examine the impact of a wide range of internalizing/externalizing psychological problems on sleep disturbance. A total of 2134 Chinese college students (60.2% men) with mental health problems were selected as participants after completing the self-reported Chinese college student mental health screening scale. A web-based survey was used to assess a wide variety of internalizing/externalizing psychological problems and sleep disturbance. The results showed that hostility, somatic symptoms and obsessive-compulsive symptoms (OCS) were significantly associated with sleep disturbance. Somatic symptoms played a mediating role in the relationship between hostility and sleep disturbance. Moreover, the mediating effect was moderated by OCS, and a significant difference in the mediating effects was observed between low OCS and high OCS groups. Overall, our research findings indicate that a high level of OCS exacerbates the adverse effects of somatic symptoms on sleep disturbance, and suggests that assessment and improvement of hostility, somatic symptoms and OCS should be considered in facilitating better sleep among college students with mental health problems.
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Affiliation(s)
- Yanping Sun
- Department of Applied Psychology, College of Sports and Health, Shandong Sport University, Jinan 250102, China
| | - Lin Wang
- Student Affairs Office, Shandong Sport University, Jinan 250102, China
| | - Chang Li
- Department of Insurance, Shandong University of Finance and Economics, Jinan 250014, China
| | - Wanshu Luo
- School of Dance, Shandong Youth University of Political Science, Jinan 250103, China
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23
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Vujanovic AA, Kauffman BY, Zegel M, Zvolensky MJ. COVID-related stress and substance use: examining the role of sleep disturbance. Cogn Behav Ther 2022; 51:486-502. [PMID: 35762877 PMCID: PMC9764365 DOI: 10.1080/16506073.2022.2079557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Accepted: 05/13/2022] [Indexed: 11/03/2022]
Abstract
The current investigation employed a cross-sectional design to evaluate the associations of COVID-19 stress, sleep disturbance, and substance use among a national sample of 143 adults (57.3% male, Mage = 38.5 years, SD = 11.28), surveyed at a single time-point using Amazon's MTurk platform. We hypothesized that COVID-19-related stress would be indirectly related to substance use outcomes (i.e. number of substance classes used daily, number of alcoholic drinks per occasion, substance use coping motives; but not substance use enhancement motives) through sleep disturbance severity. As expected, results indicated that the models examining indirect effects were statistically significant for number of substance classes used daily and substance use coping motives. However, there was no evidence that sleep disturbance explained the relation between COVID-19-related stress and number of alcoholic drinks per occasion or substance use enhancement motives. These findings underscore the importance of sleep disturbance in efforts to better understand how COVID-19-related stress is associated with certain types of substance use behavior.
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Affiliation(s)
| | | | | | - Michael J. Zvolensky
- University of Houston
- HEALTH Institute
- The University of Texas MD Anderson Cancer Center
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24
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ORUCH R, HUNEIF MA, PRYME IF, FASMER OB, LUND A. Drug treatment of insomnia: impact of zopiclone. GAZZETTA MEDICA ITALIANA ARCHIVIO PER LE SCIENZE MEDICHE 2022. [DOI: 10.23736/s0393-3660.22.04792-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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25
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Mills L, Dunlop A, Montebello M, Copeland J, Bruno R, Jefferies M, Mcgregor I, Lintzeris N. Correlates of treatment engagement and client outcomes: results of a randomised controlled trial of nabiximols for the treatment of cannabis use disorder. Subst Abuse Treat Prev Policy 2022; 17:67. [PMID: 36209081 PMCID: PMC9548192 DOI: 10.1186/s13011-022-00493-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/13/2022] [Indexed: 12/03/2022] Open
Abstract
INTRODUCTION AND AIMS There is increasing interest and evidence for the use of cannabinoid medications in the treatment of cannabis use disorder, but little examination of the correlates of successful treatment. This paper is a secondary analysis of a randomised placebo-controlled trial of nabiximols for the treatment of cannabis use disorder (CUD), aiming to identify which client and treatment characteristics impact treatment engagement and outcomes. METHOD Bayesian multiple regression models were used to examine the impact of age, gender, duration of regular cannabis use, daily quantity of cannabis, cannabis use problems, self-efficacy for quitting, sleep, mental health, pain measures, and treatment group upon treatment engagement (retention, medication dose, and counselling participation) and treatment outcomes (achieving end-of-study abstinence, and a 50% or greater reduction in cannabis use days) among the 128 clients participating in the 12-week trial. RESULTS Among the treatment factors, greater counselling attendance was associated with greater odds of abstinence and ≥ 50% reduction in cannabis use; nabiximols with greater odds of ≥ 50% reduction and attending counselling, and reduced hazard of treatment dropout; and higher dose with lower odds of ≥ 50% reduction. Among the client factors, longer duration of regular use was associated with higher odds of abstinence and 50% reduction, and lower hazard of treatment dropout; greater quantity of cannabis use with reduced hazard of dropout, greater odds of attending counselling, and higher average dose; greater pain at baseline with greater odds of ≥ 50% reduction and higher average dose; and more severe sleep issues with lower odds of ≥ 50% reduction. Males had lower odds of attending counselling. DISCUSSIONS AND CONCLUSIONS These findings suggest that counselling combined with agonist pharmacotherapy may provide the optimal treatment for cannabis use disorder. Younger clients, male clients, and clients with sleep issues could benefit from extra support from treatment services to improve engagement and outcomes. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry (ACTRN12616000103460) https://www.anzctr.org.au.
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Affiliation(s)
- Llewellyn Mills
- grid.482212.f0000 0004 0495 2383Drug and Alcohol Services, South East Sydney Local Health District, Caringbah, NSW Australia ,grid.1013.30000 0004 1936 834XSpecialty of Addiction Medicine, Faculty Medicine, and Health, University of Sydney, Camperdown, NSW Australia ,grid.1005.40000 0004 4902 0432National Drug and Alcohol Research Centre, University of New South Wales, Kensington, NSW Australia ,grid.416088.30000 0001 0753 1056NSW Drug and Alcohol Clinical Research and Improvement Network (DACRIN), NSW Health, St Leonards, Australia
| | - Adrian Dunlop
- grid.3006.50000 0004 0438 2042Drug and Alcohol Services, Hunter New England Local Health District, New Lambton, NSW Australia ,grid.266842.c0000 0000 8831 109XPriority Research Centre for Brain and Mental Health, School of Medicine and Public Health, University of Newcastle, Callaghan, NSW Australia ,grid.482157.d0000 0004 0466 4031Drug and Alcohol Services, Northern Sydney Local Health District, Hornsby, Australia
| | - Mark Montebello
- grid.1013.30000 0004 1936 834XSpecialty of Addiction Medicine, Faculty Medicine, and Health, University of Sydney, Camperdown, NSW Australia ,grid.1005.40000 0004 4902 0432National Drug and Alcohol Research Centre, University of New South Wales, Kensington, NSW Australia ,grid.416088.30000 0001 0753 1056NSW Drug and Alcohol Clinical Research and Improvement Network (DACRIN), NSW Health, St Leonards, Australia ,grid.482157.d0000 0004 0466 4031Drug and Alcohol Services, Northern Sydney Local Health District, Hornsby, Australia
| | - Jan Copeland
- grid.1005.40000 0004 4902 0432National Drug and Alcohol Research Centre, University of New South Wales, Kensington, NSW Australia ,grid.1034.60000 0001 1555 3415Mind and Neuroscience - Thompson Institute, University of the Sunshine Coast, Sippy Downs, QLD Australia
| | - Raimondo Bruno
- grid.1005.40000 0004 4902 0432National Drug and Alcohol Research Centre, University of New South Wales, Kensington, NSW Australia ,grid.1009.80000 0004 1936 826XUniversity of Tasmania, Hobart, TAS Australia
| | - Meryem Jefferies
- grid.482212.f0000 0004 0495 2383Drug Health, Western Sydney Local Health District, North Parramatta, NSW Australia
| | - Iain Mcgregor
- grid.1013.30000 0004 1936 834XSchool of Psychology, University Sydney, Camperdown, NSW Australia ,grid.1013.30000 0004 1936 834XLambert Initiative Cannabinoid Therapeutics, University Sydney, Camperdown, NSW Australia
| | - Nicholas Lintzeris
- grid.482212.f0000 0004 0495 2383Drug and Alcohol Services, South East Sydney Local Health District, Caringbah, NSW Australia ,grid.1013.30000 0004 1936 834XSpecialty of Addiction Medicine, Faculty Medicine, and Health, University of Sydney, Camperdown, NSW Australia ,grid.3006.50000 0004 0438 2042Drug and Alcohol Services, Hunter New England Local Health District, New Lambton, NSW Australia
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26
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Matos YL, Morelhão PK, Dokkedal-Silva V, Tufik S, Andersen ML. The potential role of sleep symptoms in tobacco withdrawal for the success of cessation therapies. Sleep Breath 2022; 26:1363-1364. [PMID: 34386890 DOI: 10.1007/s11325-021-02474-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 08/03/2021] [Accepted: 08/09/2021] [Indexed: 10/20/2022]
Affiliation(s)
- Ygor L Matos
- Departamento de Psicobiologia, Universidade Federal de São Paulo, UNIFESP, Rua Napoleão de Barros, 925, São Paulo, SP, 04024-002, Brazil
| | - Priscila K Morelhão
- Departamento de Psicobiologia, Universidade Federal de São Paulo, UNIFESP, Rua Napoleão de Barros, 925, São Paulo, SP, 04024-002, Brazil
| | - Vinícius Dokkedal-Silva
- Departamento de Psicobiologia, Universidade Federal de São Paulo, UNIFESP, Rua Napoleão de Barros, 925, São Paulo, SP, 04024-002, Brazil
| | - Sergio Tufik
- Departamento de Psicobiologia, Universidade Federal de São Paulo, UNIFESP, Rua Napoleão de Barros, 925, São Paulo, SP, 04024-002, Brazil
| | - Monica L Andersen
- Departamento de Psicobiologia, Universidade Federal de São Paulo, UNIFESP, Rua Napoleão de Barros, 925, São Paulo, SP, 04024-002, Brazil.
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27
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Shahveisi K, Abdoli N, Khazaie H, Farnia V, Khodamoradi M. Maternal sleep deprivation affects extinction and reinstatement of methamphetamine reward memory in male offspring: role of the D1-like and D2-like dopamine receptors. Brain Res 2022; 1792:148033. [PMID: 35905786 DOI: 10.1016/j.brainres.2022.148033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Revised: 07/09/2022] [Accepted: 07/23/2022] [Indexed: 11/28/2022]
Abstract
Maternal sleep-deprivation (MSD) has been shown to induce stress, hyperactivity, and risk taking behavior in the offspring; howbeit, it is not yet clear whether it may also affect vulnerability to psychostimulant abuse in the offspring. We aimed to determine whether MSD affects extinction and reinstatement of methamphetamine (METH) reward memory in the offspring and also to evaluate the possible role of dopamine D1-like and D2-like receptors in these processes. Thirty-day-old male offspring born to control and sleep-deprived dams (during the third week of pregnancy) were trained to acquire METH-induced place preference (2 mg/kg., i.p.). METH reward memory was then reinstated following an 8-day period of extinction. The offspring received SCH 23390 (0.03 or 0.1 mg/kg, i.p.) or sulpiride (20 or 60 mg/kg, i.p.) as antagonists of dopamine D1-like and D2-like receptors, respectively, either immediately after each daily extinction session or prior to the reinstatement session. MSD postponed METH extinction and facilitated METH reinstatement in the offspring. SCH 23390 facilitated METH extinction and decreased reinstatement of the extinguished METH preference. Sulpiride in the offspring from sleep-deprived dams facilitated METH extinction, but it did not affect reinstatement of the extinguished METH place preference. It seems that MSD may enhance vulnerability to METH abuse in the offspring. Furthermore, both dopamine D1-like and D2-like receptors may mediate METH extinction in the offspring born to the sleep-deprived dams; however, only the dopamine D1 receptor may play an important role in reinstating the extinguished METH reward memory in the offspring.
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Affiliation(s)
- Kaveh Shahveisi
- Sleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Nasrin Abdoli
- Substance Abuse Prevention Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Habibolah Khazaie
- Sleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Vahid Farnia
- Substance Abuse Prevention Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mehdi Khodamoradi
- Substance Abuse Prevention Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran.
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28
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Hatoum AS, Winiger EA, Morrison CL, Johnson EC, Agrawal A. Characterisation of the genetic relationship between the domains of sleep and circadian-related behaviours with substance use phenotypes. Addict Biol 2022; 27:e13184. [PMID: 35754104 PMCID: PMC10038127 DOI: 10.1111/adb.13184] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 04/20/2022] [Accepted: 05/07/2022] [Indexed: 12/14/2022]
Abstract
Sleep problems and substance use frequently co-occur. While substance use can result in specific sleep deficits, genetic pleiotropy could explain part of the relationship between sleep and substance use and use disorders. Here we use the largest publicly available genome-wide summary statistics of substance use behaviours (N = 79,729-632,802) and sleep/activity phenotypes to date (N = 85,502-449,734) to (1) assess the genetic overlap between substance use behaviours and both sleep and circadian-related activity measures, (2) estimate clusters from genetic correlations and (3) test processes of causality versus genetic pleiotropy. We found 31 genetic correlations between substance use and sleep/activity after Bonferroni correction. These patterns of overlap were represented by two genetic clusters: (1) tobacco use severity (age of first regular tobacco use and smoking cessation) and sleep health (sleep duration, sleep efficiency and chronotype) and (2) substance consumption/problematic use (drinks per day and cigarettes per day, cannabis use disorder, opioid use disorder and problematic alcohol use) and sleep problems (insomnia, self-reported short sleep duration, increased number of sleep episodes, increased sleep duration variability and diurnal inactivity) and measures of circadian-related activity (L5, M10 and sleep midpoint). Latent causal variable analyses determined that horizontal pleiotropy (rather than genetic causality) underlies a majority of the associations between substance use and sleep/circadian related measures, except one plausible genetically causal relationship for opioid use disorder on self-reported long sleep duration. Results show that shared genetics are likely a mechanism that is at least partly responsible for the overlap between sleep and substance use traits.
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Affiliation(s)
- Alexander S. Hatoum
- Washington University School of Medicine, Department of Psychiatry, Saint Louis, USA
| | - Evan A. Winiger
- Department of Psychiatry, University of Colorado School of Medicine, Denver, USA
| | - Claire L. Morrison
- Institute for Behavioral Genetics, University of Colorado, Boulder, Colorado
- Department of Psychology and Neuroscience, University of Colorado, Boulder, Colorado
| | - Emma C. Johnson
- Washington University School of Medicine, Department of Psychiatry, Saint Louis, USA
| | - Arpana Agrawal
- Washington University School of Medicine, Department of Psychiatry, Saint Louis, USA
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29
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Jones MR, Brandner AJ, Vendruscolo LF, Vendruscolo JCM, Koob GF, Schmeichel BE. Effects of Alcohol Withdrawal on Sleep Macroarchitecture and Microarchitecture in Female and Male Rats. Front Neurosci 2022; 16:838486. [PMID: 35757544 PMCID: PMC9226367 DOI: 10.3389/fnins.2022.838486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 02/22/2022] [Indexed: 11/17/2022] Open
Abstract
The prevalence of sleep disruptions is higher among people with alcohol use disorder (AUD), particularly during alcohol withdrawal, compared to non-AUD individuals. Although women generally have a higher risk of developing sleep disorders, few studies have investigated sex differences in sleep disruptions following chronic alcohol exposure. The present study examined sleep macroarchitecture (time spent asleep or awake and sleep onset latency) and microarchitecture (bout rate and duration and sleep spindle characterization) prior to alcohol vapor exposure (baseline), during acute withdrawal, and through protracted abstinence in female and male rats. Females and males showed reduced time in rapid eye movement (REM) sleep during acute withdrawal, which returned to baseline levels during protracted abstinence. REM sleep onset latency was decreased during protracted abstinence in females only. Furthermore, there was a sex difference observed in overall REM sleep bout rate. Although there were no changes in non-REM sleep time, or to non-REM sleep bout rate or duration, there was an increase in non-REM sleep intra-spindle frequency during acute withdrawal in both females and males. Finally, there was increased wakefulness time and bout duration during acute withdrawal in both females and males. The results demonstrate both macroarchitectural and microarchitectural changes in sleep following chronic alcohol exposure, particularly during acute withdrawal, suggesting the need for therapeutic interventions for sleep disturbances during withdrawal in individuals with AUD. Furthermore, sex differences were observed in REM sleep, highlighting the importance of including both sexes in future alcohol-related sleep studies.
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Affiliation(s)
- Marissa R Jones
- Department of Biomedical Sciences, Quillen College of Medicine, East Tennessee State University, Johnson City, TN, United States
| | - Adam J Brandner
- Neurobiology of Addiction Section, Integrative Neuroscience Research Branch, National Institute on Drug Abuse, Intramural Research Program, Baltimore, MD, United States
| | - Leandro F Vendruscolo
- Neurobiology of Addiction Section, Integrative Neuroscience Research Branch, National Institute on Drug Abuse, Intramural Research Program, Baltimore, MD, United States
| | - Janaina C M Vendruscolo
- Neurobiology of Addiction Section, Integrative Neuroscience Research Branch, National Institute on Drug Abuse, Intramural Research Program, Baltimore, MD, United States
| | - George F Koob
- Neurobiology of Addiction Section, Integrative Neuroscience Research Branch, National Institute on Drug Abuse, Intramural Research Program, Baltimore, MD, United States
| | - Brooke E Schmeichel
- Department of Biomedical Sciences, Quillen College of Medicine, East Tennessee State University, Johnson City, TN, United States.,Neurobiology of Addiction Section, Integrative Neuroscience Research Branch, National Institute on Drug Abuse, Intramural Research Program, Baltimore, MD, United States
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30
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Noudali SN, Patock-Peckham JA, Berberian SL, Belton DA, Campbell LE, Infurna FJ. Does insomnia mediate the link between childhood trauma and impaired control over drinking, alcohol use, and related problems? Addict Behav Rep 2022; 15:100402. [PMID: 35036516 PMCID: PMC8743204 DOI: 10.1016/j.abrep.2021.100402] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Revised: 12/06/2021] [Accepted: 12/17/2021] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Hyperarousal theory states that stressful negative events can result in a physiological response in the body leading to poor sleep quality. Childhood trauma is associated with many negative health consequences persisting into adulthood such as insomnia. Insomnia itself is a driver of poor physical and psychological health including excessive alcohol use. We examined the direct and indirect relationships between trauma (i.e., physical-neglect, physical, emotional, and sexual abuse) as well as emotionally supportive families on insomnia, impaired control over drinking, alcohol use, and alcohol-related problems. METHODS We studied a sample of 941 college students (467 women, 474 men). For our data analysis, we used a structural equation model with model indirect commands and 20,000 iteration bootstrapping with asymmetric confidence intervals in Mplus to obtain our mediated effects. RESULTS Higher levels of emotional abuse were directly associated with more insomnia. Further, higher levels of physical neglect were directly associated with more impaired control over drinking. We found several mediational pathways from this investigation as well. Higher levels of emotional abuse were indirectly linked to both more alcohol use and alcohol-related problems through increased insomnia and impaired control over drinking. CONCLUSIONS Our results were consistent with Hyperarousability Theory. We suggest that insomnia may contribute to dysregulated drinking and that combating emotional abuse could be a promising therapeutic target of intervention among college student social drinkers.
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Affiliation(s)
- Sean N. Noudali
- Department of Psychology, Arizona State University, 950 S. McAllister Ave., Tempe, AZ 85287-1104, USA
| | - Julie A. Patock-Peckham
- Department of Psychology, Arizona State University, 950 S. McAllister Ave., Tempe, AZ 85287-1104, USA
| | - Sophia L. Berberian
- Department of Psychology, Arizona State University, 950 S. McAllister Ave., Tempe, AZ 85287-1104, USA
| | - Daniel A. Belton
- Department of Psychology, Arizona State University, 950 S. McAllister Ave., Tempe, AZ 85287-1104, USA
| | - Lyndsay E. Campbell
- Department of Psychology, Arizona State University, 950 S. McAllister Ave., Tempe, AZ 85287-1104, USA
| | - Frank J. Infurna
- Department of Psychology, Arizona State University, 950 S. McAllister Ave., Tempe, AZ 85287-1104, USA
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31
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Cousin L, Roucoux G, Petit AS, Baumann-Coblentz L, Torrente OR, Cannafarina A, Chassany O, Duracinsky M, Carrieri P. Perceived stigma, substance use and self-medication in night-shift healthcare workers: a qualitative study. BMC Health Serv Res 2022; 22:698. [PMID: 35610623 PMCID: PMC9128768 DOI: 10.1186/s12913-022-08018-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 04/06/2022] [Indexed: 11/10/2022] Open
Abstract
Background Many risk factors related to altered circadian rhythms impact the health of night-shift hospital workers (NSHW), resulting in mental and somatic disorders. Easy access to psychoactive substances (PS) may facilitate addictive behaviors in NSHW. They are also exposed to a stressful work environment, which may further affect sleep quality. This study aimed to explore the link between sleep deprivation, work-related psychosocial stress and psychoactive substance use as a self-medication response in NSHW. Methods Qualitative study to verify the plausibility of the self-medication theory applied to addictive behaviors. Semi-structured interviews (N = 18 NSHW) and thematic analysis, following consolidated criteria for reporting qualitative research recommendations. Results Stigma against NSHW was a primary element of a stressful work environment. The stressful and stigmatizing environment, together with night-shift work, further affected NSHW sleep and their mental and physical health. The use of PS appeared to be for self-medication, encouraged by social and professional environments, source(s) of stress, discrimination, and isolation. The work environment, through aggravated sleep disorders, led NSHW to use non-prescribed sleeping pills. Alcohol after work and smoking were used as a social break but also as a means to reduce stress. Conclusion Anti-stigma interventions in the healthcare setting and screening of mental/somatic disorders in NSHW can help reduce harmful self-medication behaviors and improve hospital care in the COVID-19 era. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-022-08018-x.
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Affiliation(s)
- Lorraine Cousin
- Unité de Recherche Clinique en Economie de La Santé (URC-ECO), AP-HP, Hôpital Hôtel-Dieu, F-75004, Paris, France. .,Patient-Reported Outcomes Unit (PROQOL), UMRS 1123, Université Paris Cité, INSERM, F-75004, Paris, France. .,Groupe de Recherche en Psychologie Sociale (UR GRePS), Université Lyon 2, Bron, France.
| | - Guillaume Roucoux
- Unité de Recherche Clinique en Economie de La Santé (URC-ECO), AP-HP, Hôpital Hôtel-Dieu, F-75004, Paris, France.,Patient-Reported Outcomes Unit (PROQOL), UMRS 1123, Université Paris Cité, INSERM, F-75004, Paris, France
| | - Anne Sophie Petit
- Unité de Recherche Clinique en Economie de La Santé (URC-ECO), AP-HP, Hôpital Hôtel-Dieu, F-75004, Paris, France.,Groupe de Recherche en Psychologie Sociale (UR GRePS), Université Lyon 2, Bron, France
| | | | - Olivia Rousset Torrente
- Unité de Recherche Clinique en Economie de La Santé (URC-ECO), AP-HP, Hôpital Hôtel-Dieu, F-75004, Paris, France.,Patient-Reported Outcomes Unit (PROQOL), UMRS 1123, Université Paris Cité, INSERM, F-75004, Paris, France
| | - Adriano Cannafarina
- Unité de Recherche Clinique en Economie de La Santé (URC-ECO), AP-HP, Hôpital Hôtel-Dieu, F-75004, Paris, France.,Patient-Reported Outcomes Unit (PROQOL), UMRS 1123, Université Paris Cité, INSERM, F-75004, Paris, France
| | - Olivier Chassany
- Unité de Recherche Clinique en Economie de La Santé (URC-ECO), AP-HP, Hôpital Hôtel-Dieu, F-75004, Paris, France.,Patient-Reported Outcomes Unit (PROQOL), UMRS 1123, Université Paris Cité, INSERM, F-75004, Paris, France
| | - Martin Duracinsky
- Unité de Recherche Clinique en Economie de La Santé (URC-ECO), AP-HP, Hôpital Hôtel-Dieu, F-75004, Paris, France.,Patient-Reported Outcomes Unit (PROQOL), UMRS 1123, Université Paris Cité, INSERM, F-75004, Paris, France.,Département de Médecine Interne Et d'immunologie Clinique, Hôpital Bicêtre, AP-HP, 94275, Kremlin Bicêtre, France
| | - Patrizia Carrieri
- Aix Marseille Univ, Inserm, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé et Traitement de l'Information Médicale, ISSPAM, Marseille, France
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Berro LF, Overton JS, Rowlett JK. Methamphetamine-Induced Sleep Impairments and Subsequent Slow-Wave and Rapid Eye Movement Sleep Rebound in Male Rhesus Monkeys. Front Neurosci 2022; 16:866971. [PMID: 35464308 PMCID: PMC9021839 DOI: 10.3389/fnins.2022.866971] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 03/03/2022] [Indexed: 11/18/2022] Open
Abstract
Use of amphetamine-type stimulants is associated with numerous adverse health outcomes, with disturbed sleep being one of the most prominent consequences of methamphetamine use. However, the extent to which methamphetamine alters sleep architecture, and whether methamphetamine-induced sleep impairment is associated with next-day sleep rebound effects, has received relatively little investigation. In the present study, we investigated the effects of acute morning methamphetamine administration on sleep parameters in adult male rhesus monkeys (N = 4) using a fully-implantable telemetry system. Monkeys were prepared with telemetry devices that continuously monitored electroencephalography (EEG), electromyography (EMG) and electrooculography (EOG) throughout the night. We investigated the effects of morning (10h00) administration of methamphetamine (0.01-0.3 mg/kg, i.m.) on sleep during the night of the injection. In addition, we investigated sleep during the subsequent night in order to assess the possible emergence of sleep rebound effects. Methamphetamine administration dose-dependently increased sleep latency and wake time after sleep onset (WASO). Methamphetamine also decreased total sleep time, which was reflected by a decrease in total time spent in N2, slow-wave (N3) and REM sleep stages, while increasing the percentage of total sleep time spent in sleep stage N1. Importantly, methamphetamine decreased time spent in N3 and REM sleep even at doses that did not significantly decrease total sleep time. Sleep rebound effects were observed on the second night after methamphetamine administration, with increased total sleep time reflected by a selective increase in time spent in sleep stages N3 and REM, as well as a decrease in REM sleep latency. Our findings show that methamphetamine administered 8 h prior to the inactive (dark) phase induces marked changes in sleep architecture in rhesus monkeys, even at doses that do not change sleep duration, and that sleep rebound effects are observed the following day for both N3 and REM sleep stages.
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Affiliation(s)
| | - John S. Overton
- Department of Psychiatry and Human Behavior, Center for Innovation and Discovery in Addictions, University of Mississippi Medical Center, Jackson, MS, United States
| | - James K. Rowlett
- Department of Psychiatry and Human Behavior, Center for Innovation and Discovery in Addictions, University of Mississippi Medical Center, Jackson, MS, United States
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Novak JR, Gillis BT. A primer on sleep for MFTs: Implications and practical considerations. JOURNAL OF MARITAL AND FAMILY THERAPY 2022; 48:543-559. [PMID: 33982307 DOI: 10.1111/jmft.12528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 04/12/2021] [Accepted: 04/22/2021] [Indexed: 06/12/2023]
Abstract
Despite many marriage and family therapists (MFTs) utilizing the Biopsychosocial-Spiritual (BPSS) framework in assessment and treatment, there is still a lack of education on sleep and the implications for mental, emotional, and relational health. Newer research within many fields highlights the far-reaching spillover effects of short or poor-quality sleep that can affect our clients. MFTs need to know how to assess, how to provide proper psychoeducation, how to apply this knowledge in clinical settings, and how to collaborate with other healthcare providers. As such, the purpose of this article is threefold: (a) review the biopsychosocial-spiritual importance of sleep; (b) equip MFTs with information on sleep assessment, how to identify situations for referral, and how to provide psychoeducation on sleep hygiene; and (c) review important considerations for research and practice for MFTs.
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Affiliation(s)
- Joshua R Novak
- Department of Human Development and Family Science, Auburn University, Auburn, AL, USA
| | - Brian T Gillis
- Department of Human Development and Family Science, Auburn University, Auburn, AL, USA
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Cousin L, Di Beo V, Marcellin F, Coscas S, Mahé V, Chavignaud I, Rousset Torrente O, Chassany O, Duracinsky M, Carrieri MP. Use of psychoactive substances by night-shift hospital healthcare workers during the first wave of the COVID-19 pandemic: a cross-sectional study based in Parisian public hospitals (ALADDIN). BMJ Open 2022; 12:e055699. [PMID: 35246420 PMCID: PMC8918090 DOI: 10.1136/bmjopen-2021-055699] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
OBJECTIVES This study aimed to estimate the prevalence of psychoactive substance (PAS) use in night-shift healthcare workers (NSHW) during France's first COVID-19 wave (March-May 2020). DESIGN Observational cross-sectional online survey. SETTING 39 public hospitals in the Assitance Publique des Hôpitaux de Paris (AP-HP) network in the Parisian area. PARTICIPANTS A total of 1238 nurses, assistant nurses, X-ray technicians, managers, lab technicians, midwives and childcare assistants working at night or alternating between days and nights answered the questionnaire. INTERVENTION Online survey. OUTCOME MEASURES PAS use prevalence after weighting data for sex, age and profession using calibration on margins, in order to be representative of all AP-HP NSHW. We used the Fagerström scale and the Alcohol Use Disorders Identification Test Concise to assess PAS use. RESULTS The weighted estimated prevalences of daily smoking, alcohol drinking and tranquilliser use in participating NSHW were 21.4, 1.3 and 2.4%, respectively. Twelve per cent (11.7%) of our study sample used opioids. During the first COVID-19 wave, PAS use remained stable except for tobacco use, with 8.6% of participants reporting an increase. Previous 3-month prevalences of tranquilliser and opioid use were significantly higher than in the general population. CONCLUSION Daily smoking (especially in younger men) and tranquilliser and opioid use were highly prevalent in NSHW in the AP-HP network during France's first COVID-19 wave. Specific interventions for quitting smoking and addressing determinants of tranquilliser and opioid use in NSHW need to be developed and evaluated to improve quality of life in these essential, underdiagnosed and undertreated health personnel.
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Affiliation(s)
- Lorraine Cousin
- Unité de Recherche Clinique en Economie de la Santé (URC-ECO), F-75004, Assistance Publique - Hopitaux de Paris, Paris, France
- Patient-Reported Outcomes Unit (PROQOL), UMR 1123, INSERM, F-75004, Université de Paris, Paris, France
- Inserm, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, ISSPAM, Marseille, Aix-Marseille Université, Marseille, France
| | - Vincent Di Beo
- Inserm, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, ISSPAM, Marseille, Aix-Marseille Université, Marseille, France
| | - Fabienne Marcellin
- Inserm, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, ISSPAM, Marseille, Aix-Marseille Université, Marseille, France
| | - Sarah Coscas
- Mission FIDES, AP-HP, hôpital Paul Brousse, Villejuif, Assistance Publique - Hopitaux de Paris, Paris, France
- UR psychiatrie-comorbidités-addictions (PSYCOMadd), Assistance Publique - Hopitaux de Paris, Villejuif, France
| | - Véronique Mahé
- Service de santé au travail, hôpitaux Lariboisière-Fernand Widal, Assistance Publique - Hopitaux de Paris, Paris, France
| | - Isabelle Chavignaud
- Mission FIDES, AP-HP, hôpital Paul Brousse, Villejuif, Assistance Publique - Hopitaux de Paris, Paris, France
| | - Olivia Rousset Torrente
- Unité de Recherche Clinique en Economie de la Santé (URC-ECO), F-75004, Assistance Publique - Hopitaux de Paris, Paris, France
- Patient-Reported Outcomes Unit (PROQOL), UMR 1123, INSERM, F-75004, Université de Paris, Paris, France
| | - Olivier Chassany
- Unité de Recherche Clinique en Economie de la Santé (URC-ECO), F-75004, Assistance Publique - Hopitaux de Paris, Paris, France
- Patient-Reported Outcomes Unit (PROQOL), UMR 1123, INSERM, F-75004, Université de Paris, Paris, France
| | - Martin Duracinsky
- Unité de Recherche Clinique en Economie de la Santé (URC-ECO), F-75004, Assistance Publique - Hopitaux de Paris, Paris, France
- Patient-Reported Outcomes Unit (PROQOL), UMR 1123, INSERM, F-75004, Université de Paris, Paris, France
- Département de médecine interne et d'immunologie clinique, Assistance Publique - Hopitaux de Paris, Kremlin Bicêtre, France
| | - Maria Patrizia Carrieri
- Inserm, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, ISSPAM, Marseille, Aix-Marseille Université, Marseille, France
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Eacret D, Lemchi C, Caulfield JI, Cavigelli SA, Veasey SC, Blendy JA. Chronic Sleep Deprivation Blocks Voluntary Morphine Consumption but Not Conditioned Place Preference in Mice. Front Neurosci 2022; 16:836693. [PMID: 35250468 PMCID: PMC8892254 DOI: 10.3389/fnins.2022.836693] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 01/24/2022] [Indexed: 12/26/2022] Open
Abstract
The opioid epidemic remains a significant healthcare problem and is attributable to over 100,000 deaths per year. Poor sleep increases sensitivity to pain, impulsivity, inattention, and negative affect, all of which might perpetuate drug use. Opioid users have disrupted sleep during drug use and withdrawal and report poor sleep as a reason for relapse. However, preclinical studies investigating the relationship between sleep loss and substance use and the associated underlying neurobiological mechanisms of potential interactions are lacking. One of the most common forms of sleep loss in modern society is chronic short sleep (CSS) (<7 h/nightly for adults). Here, we used an established model of CSS to investigate the influence of disrupted sleep on opioid reward in male mice. The CSS paradigm did not increase corticosterone levels or depressive-like behavior after a single sleep deprivation session but did increase expression of Iba1, which typically reflects microglial activation, in the hypothalamus after 4 weeks of CSS. Rested control mice developed a morphine preference in a 2-bottle choice test, while mice exposed to CSS did not develop a morphine preference. Both groups demonstrated morphine conditioned place preference (mCPP), but there were no differences in conditioned preference between rested and CSS mice. Taken together, our results show that recovery sleep after chronic sleep disruption lessens voluntary opioid intake, without impacting conditioned reward associated with morphine.
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Affiliation(s)
- Darrell Eacret
- Department of Systems Pharmacology and Translational Therapeutics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Crystal Lemchi
- Department of Systems Pharmacology and Translational Therapeutics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Jasmine I. Caulfield
- Huck Institute for Life Sciences, Pennsylvania State University, University Park, PA, United States
| | - Sonia A. Cavigelli
- Huck Institute for Life Sciences, Pennsylvania State University, University Park, PA, United States
| | - Sigrid C. Veasey
- Department of Medicine, Center for Sleep and Circadian Neurobiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Julie A. Blendy
- Department of Systems Pharmacology and Translational Therapeutics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
- *Correspondence: Julie A. Blendy,
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Sharma R, Parikh M, Mishra V, Zuniga A, Sahota P, Thakkar M. Sleep, sleep homeostasis and arousal disturbances in alcoholism. Brain Res Bull 2022; 182:30-43. [PMID: 35122900 DOI: 10.1016/j.brainresbull.2022.01.022] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 01/12/2022] [Accepted: 01/29/2022] [Indexed: 12/11/2022]
Abstract
The effects of alcohol on human sleep were first described almost 70 years ago. Since then, accumulating evidences suggest that alcohol intake at bed time immediately induces sleep [reduces the time to fall asleep (sleep onset latency), and consolidates and enhances the quality (delta power) and the quantity of sleep]. Such potent sleep promoting activity makes alcohol as one of the most commonly used "over the counter" sleep aid. However, the somnogenic effects, after alcohol intake, slowly wane off and often followed by sleep disruptions during the rest of the night. Repeated use of alcohol leads to the development of rapid tolerance resulting into an alcohol abuse. Moreover, chronic and excessive alcohol intake leads to the development of alcohol use disorder (AUD). Alcoholics, both during drinking periods and during abstinences, suffer from a multitude of sleep disruptions manifested by profound insomnia, excessive daytime sleepiness, and altered sleep architecture. Furthermore, subjective and objective indicators of sleep disturbances are predictors of relapse. Finally, within the USA, it is estimated that societal costs of alcohol-related sleep disorders exceed $18 billion. Thus, although alcohol associated sleep problems have significant economic and clinical consequences, very little is known about how and where alcohol acts to affect sleep. In this review, a conceptual framework and clinical research focused on understanding the relationship between alcohol and sleep is first described. In the next section, our new and exciting preclinical studies, to understand the cellular and molecular mechanism of how acute and chronic alcohol affects sleep, are described. In the end, based on observations from our recent findings and related literature, opportunities for the development of innovative strategies to prevent and treat AUD are proposed.
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Affiliation(s)
- Rishi Sharma
- Harry S. Truman Memorial Veterans Hospital and Department of Neurology, University of Missouri, Columbia MO 65201
| | - Meet Parikh
- Harry S. Truman Memorial Veterans Hospital and Department of Neurology, University of Missouri, Columbia MO 65201
| | - Vaibhav Mishra
- Harry S. Truman Memorial Veterans Hospital and Department of Neurology, University of Missouri, Columbia MO 65201
| | - Abigail Zuniga
- Harry S. Truman Memorial Veterans Hospital and Department of Neurology, University of Missouri, Columbia MO 65201
| | - Pradeep Sahota
- Harry S. Truman Memorial Veterans Hospital and Department of Neurology, University of Missouri, Columbia MO 65201
| | - Mahesh Thakkar
- Harry S. Truman Memorial Veterans Hospital and Department of Neurology, University of Missouri, Columbia MO 65201.
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Matzeu A, Martin-Fardon R. Understanding the Role of Orexin Neuropeptides in Drug Addiction: Preclinical Studies and Translational Value. Front Behav Neurosci 2022; 15:787595. [PMID: 35126069 PMCID: PMC8811192 DOI: 10.3389/fnbeh.2021.787595] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 12/29/2021] [Indexed: 12/22/2022] Open
Abstract
Orexins (also known as hypocretins) are neuropeptides that participate in the regulation of energy metabolism, homeostasis, sleep, feeding, stress responses, arousal, and reward. Particularly relevant to the scope of the present review is the involvement of the orexin system in brain mechanisms that regulate motivation, especially highly motivated behavior, arousal, and stress, making it an ideal target for studying addiction and discovering treatments. Drug abuse and misuse are thought to induce maladaptive changes in the orexin system, and these changes might promote and maintain uncontrolled drug intake and contribute to relapse. Dysfunctional changes in this neuropeptidergic system that are caused by drug use might also be responsible for alterations of feeding behavior and the sleep-wake cycle that are commonly disrupted in subjects with substance use disorder. Drug addiction has often been associated with an increase in activity of the orexin system, suggesting that orexin receptor antagonists may be a promising pharmacological treatment for substance use disorder. Substantial evidence has shown that single orexin receptor antagonists that are specific to either orexin receptor 1 or 2 can be beneficial against drug intake and relapse. Interest in the efficacy of dual orexin receptor antagonists, which were primarily developed to treat insomnia, has grown in the field of drug addiction. Treatments that target the orexin system may be a promising strategy to reduce drug intake, mitigate relapse vulnerability, and restore “normal” physiological functions, including feeding and sleep. The present review discusses preclinical and clinical evidence of the involvement of orexins in drug addiction and possible beneficial pharmacotherapeutic effects of orexin receptor antagonists to treat substance use disorder.
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Reichmann G, Parlier-Ahmad AB, Beck L, Thakkar B, Alappattu M, Boissoneault J, Martin CE. Chronic Pelvic Pain and Sexual Dysfunction Among Females and Males Receiving Treatment for Opioid Use Disorder. FRONTIERS IN PAIN RESEARCH 2022; 2:787559. [PMID: 35295502 PMCID: PMC8915557 DOI: 10.3389/fpain.2021.787559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 11/30/2021] [Indexed: 11/13/2022] Open
Abstract
Introduction: Chronic pain brings complexity to opioid use disorder (OUD). Psychosocial and neurobiological risks for Chronic Pelvic Pain (CPP) and OUD overlap. The primary objective of this exploratory study is to compare sex-specific prevalence of CPP and sexual dysfunction between individuals receiving buprenorphine for OUD and a comparison group receiving treatment for other chronic medical conditions (CMC).Methods: Participants from an OUD treatment (n = 154) and primary care clinic (n = 109) completed a survey between July 2019 and February 2020 assessing reproductive and sexual health. Sex-stratified CPP and pain interference measures were adapted from the Brief Pain Inventory for females, and for males, the Brief Male Sexual Function Inventory and NIH Chronic Prostatitis Symptom Index. The Male and Female Sexual Function Index assessed sexual dysfunction. Prevalence of CPP and sexual dysfunction between groups were compared using Pearson χ2 and Fisher's Exact tests.Results: Participants were 54.4% female and 75.0% Black with almost half having a psychiatric diagnosis. Among OUD females, the highest pain severity reported was for menstrual-related pain, and for OUD males, testicular pain. CPP most interfered with mood in OUD females vs. sleep and enjoyment of life in OUD males. There were no differences in prevalence for global sexual dysfunction with 91.6% of females and 84.2% of males screening positive across groups.Discussion/Implications: CPP and sexual dysfunction are important components of wellness and may play a role in OUD recovery trajectories. The value of addressing CPP and sexual dysfunction in tailored comprehensive, sex-informed OUD treatment approaches should be further investigated.
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Affiliation(s)
- Geetika Reichmann
- School of Medicine, Virginia Commonwealth University, Richmond, VA, United States
| | | | - Lori Beck
- Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, VA, United States
| | - Bhushan Thakkar
- Department of Obstetrics and Gynecology, Virginia Commonwealth University, Richmond, VA, United States
| | - Meryl Alappattu
- Department of Physical Therapy, University of Florida, Gainesville, FL, United States
| | - Jeff Boissoneault
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, United States
| | - Caitlin E. Martin
- School of Medicine, Virginia Commonwealth University, Richmond, VA, United States
- Department of Obstetrics and Gynecology, Virginia Commonwealth University, Richmond, VA, United States
- Institute for Drug and Alcohol Studies, Virginia Commonwealth University, Richmond, VA, United States
- *Correspondence: Caitlin E. Martin
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Shahveisi K, Abdoli N, Farnia V, Khazaie H, Hosseini M, Ghazvini H, Khodamoradi M. REM sleep deprivation before extinction or reinstatement alters methamphetamine reward memory via D1-like dopamine receptors. Pharmacol Biochem Behav 2022; 213:173319. [PMID: 34990706 DOI: 10.1016/j.pbb.2021.173319] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 11/26/2021] [Accepted: 12/25/2021] [Indexed: 12/14/2022]
Abstract
We aimed to determine whether REM sleep deprivation (RSD) affects extinction and reinstatement of methamphetamine (METH) reward memory in male rats and also to evaluate the possible role of dopamine D1-like and D2-like dopamine (DA) receptors in these processes. Male rats were trained to acquire METH-induced place preference (2 mg/kg, i.p.). METH reward memory was then reinstated following a 10-day extinction period. The animals underwent a 72-hour sleep deprivation episode by multiple platforms method (in separate groups), either before the extraction or before the reinstatement of METH reward memory. The animals received SCH 23390 (0.01 or 0.05 mg/kg, i.p.) or sulpiride (20 or 60 mg/kg, i.p.) as antagonists of D1-like and D2-like DA receptors, respectively, either immediately following each daily extinction session or before the reinstatement of METH-seeking behavior. The RSD episode postponed extinction and facilitated reinstatement of METH reward memory. Administration of SCH 23390, but not sulpiride, facilitated METH extinction and decreased reinstatement of the extinguished METH-seeking behavior. Moreover, locomotor activity was not affected by METH and/or the RSD paradigm. The results would seem to suggest that the D1-like, but not the D2-like, DA receptors may be involved in the extinction and reinstatement of the extinguished METH reward memory in RSD animals. Nonetheless, more investigations are needed to elucidate the exact mechanisms involved.
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Affiliation(s)
- Kaveh Shahveisi
- Sleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Nasrin Abdoli
- Substance Abuse Prevention Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Vahid Farnia
- Substance Abuse Prevention Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Habibolah Khazaie
- Sleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mahmoud Hosseini
- Division of Neurocognitive Sciences, Psychiatry and Behavioral Sciences Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hamed Ghazvini
- Department of Neuroscience, School of Advanced Technologies in Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mehdi Khodamoradi
- Substance Abuse Prevention Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran.
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Sleep dysregulation in binge eating disorder and "food addiction": the orexin (hypocretin) system as a potential neurobiological link. Neuropsychopharmacology 2021; 46:2051-2061. [PMID: 34145404 PMCID: PMC8505614 DOI: 10.1038/s41386-021-01052-z] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 05/26/2021] [Accepted: 05/28/2021] [Indexed: 12/12/2022]
Abstract
It has been proposed that binge eating reflects a pathological compulsion driven by the "addictive" properties of foods. Proponents of this argument highlight the large degree of phenomenological and diagnostic overlap between binge eating disorder (BED) and substance use disorders (SUDs), including loss of control over how much is consumed and repeated unsuccessful attempts to abstain from consumption, as well as commonalities in brain structures involved in food and drug craving. To date, very little attention has been given to an additional behavioral symptom that BED shares with SUDs-sleep dysregulation-and the extent to which this may contribute to the pathophysiology of BED. Here, we review studies examining sleep outcomes in patients with BED, which collectively point to a heightened incidence of sleep abnormalities in BED. We identify the orexin (hypocretin) system as a potential neurobiological link between compulsive eating and sleep dysregulation in BED, and provide a comprehensive update on the evidence linking this system to these processes. Finally, drawing on evidence from the SUD literature indicating that the orexin system exhibits significant plasticity in response to drugs of abuse, we hypothesize that chronic palatable food consumption likewise increases orexin system activity, resulting in dysregulated sleep/wake patterns. Poor sleep, in turn, is predicted to exacerbate binge eating, contributing to a cycle of uncontrolled food consumption. By extension, we suggest that pharmacotherapies normalizing orexin signaling, which are currently being trialed for the treatment of SUDs, might also have utility in the clinical management of BED.
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Kale HP, Qureshi ZP, Shah R, Khandker R, Botteman M, Meng W, Benca R. Changes in Healthcare Resource Use and Costs in Commercially Insured Insomnia Patients Initiating Suvorexant. Adv Ther 2021; 38:5221-5237. [PMID: 34463922 PMCID: PMC8478735 DOI: 10.1007/s12325-021-01891-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 08/06/2021] [Indexed: 11/18/2022]
Abstract
INTRODUCTION Insomnia diagnosis has been associated with a significant clinical and economic burden on patients and healthcare systems. This study examined changes in healthcare resource use (HCRU) and costs in insomnia patients before and after initiation of suvorexant treatment. METHODS This retrospective cohort study analyzed Optum Clinformatics Data Mart claims data (Jan 2010-Dec 2018). Patients with ≥ 2 insomnia diagnosis claims and ≥ 1 prescription for suvorexant were included. Prevalent and incident insomnia patients were analyzed separately. The change in the trends of HCRU and costs were examined for 12 months before and 12 months after suvorexant initiation. An interrupted time series (ITS) analysis was conducted to assess the level and slope changes. Subgroups of patients with mental health comorbidities were examined. RESULTS The study included 18,919 and 5939 patients in the prevalent and incident insomnia cohorts, respectively. For the prevalent cohort, mean (SD) age was 64.5 (14.1) years, 65% were female, 74% had Medicare Advantage coverage, and 61% had a Charlson comorbidity index score ≥ 1. Characteristics for the incident cohort were similar. The ITS results suggested that the trend for monthly total healthcare cost (THC) was increasing before suvorexant initiation (US$52.51 in the prevalent cohort, $74.93 in incident insomnia cohort), but, after suvorexant initiation, the monthly total cost showed a decreasing trend in both cohorts. The decrease in slope for THC after suvorexant initiation were $72.66 and $112.07 per month in the prevalent and incident cohorts, respectively. The monthly trends in HCRU rates also decreased. The subgroup analysis showed that decreases were 1.5-3 times greater for patients with mental health comorbidities. CONCLUSIONS In this real-world study, suvorexant initiation was associated with immediate and continued decreases in HCRU and costs in insomnia patients. Further research is needed to understand the effect of suvorexant initiation on direct medical costs as well as costs associated with lost productivity in other real-world settings.
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Affiliation(s)
| | - Zaina P Qureshi
- Merck & Co., Inc, 2000 Galloping Hill Rd, Kenilworth, NJ, USA.
| | - Ruchit Shah
- OPEN Health Evidence & Access, Bethesda, MD, USA
| | - Rezaul Khandker
- Merck & Co., Inc, 2000 Galloping Hill Rd, Kenilworth, NJ, USA
| | | | - Weilin Meng
- Merck & Co., Inc, 2000 Galloping Hill Rd, Kenilworth, NJ, USA
| | - Ruth Benca
- University of California, Irvine, Irvine, CA, USA
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The dual orexin receptor antagonist almorexant blocks the sleep-disrupting and daytime stimulant effects of methamphetamine in rhesus monkeys. Drug Alcohol Depend 2021; 227:108930. [PMID: 34358767 PMCID: PMC8464508 DOI: 10.1016/j.drugalcdep.2021.108930] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 06/09/2021] [Accepted: 06/10/2021] [Indexed: 01/06/2023]
Abstract
BACKGROUND The present study investigated the effects of the dual orexin receptor antagonist (DORA) almorexant, a sleep-modulating drug, on the sleep-disrupting effects of methamphetamine in adult rhesus monkeys. METHODS Monkeys were fitted with primate collars to which actigraphy monitors were attached. To determine the effects of methamphetamine on daytime activity and sleep-like parameters, monkeys were given acute injections of vehicle or methamphetamine (0.03, 0.1 or 0.3 mg/kg, i.m.) in the morning (9:00 h) (n = 4 males). We then determined the ability of almorexant to alter the daytime and/or sleep-like effects of the largest (effective) dose of methamphetamine. Vehicle or almorexant (1, 3 or 10 mg/kg, i.m.) were administered in the evening (16:30 h, 1.5 h before "lights off") following morning (9:00 h) administration of methamphetamine (0.3 mg/kg, i.m.), or as a pretreatment (8:30 h) before methamphetamine injections (9:00 h) (n = 4 males). The ability of almorexant (10 mg/kg) to improve sleep-like behaviors also was assessed in a group of monkeys quantitatively identified with short-duration sleep (n = 2 males, 2 females). RESULTS Morning methamphetamine administration dose-dependently impaired sleep in rhesus monkeys (0.3 mg/kg significantly increased sleep latency and decreased sleep efficiency). Administration of almorexant, both as a pretreatment or as an evening treatment, improved methamphetamine-induced sleep impairment in a dose dependent manner. Morning pretreatment with almorexant also blocked the daytime stimulant effects of methamphetamine. Evening, but not morning, treatment with almorexant in a group of monkeys with baseline short-duration sleep improved sleep measures. CONCLUSIONS Our findings indicate that orexin receptor systems are involved in methamphetamine-induced hyperarousal and sleep disruption.
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O'Brien CB, Locklear CE, Glovak ZT, Zebadúa Unzaga D, Baghdoyan HA, Lydic R. Opioids cause dissociated states of consciousness in C57BL/6J mice. J Neurophysiol 2021; 126:1265-1275. [PMID: 34469699 DOI: 10.1152/jn.00266.2021] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
The electroencephalogram (EEG) provides an objective, neural correlate of consciousness. Opioid receptors modulate mammalian neuronal excitability, and this fact was used to characterize how opioids administered to mice alter EEG power and states of consciousness. The present study tested the hypothesis that antinociceptive doses of fentanyl, morphine, or buprenorphine differentially alter the EEG and states of sleep and wakefulness in adult, male C57BL/6J mice. Mice were anesthetized and implanted with telemeters that enabled wireless recordings of cortical EEG and electromyogram (EMG). After surgical recovery, EEG and EMG were used to objectively score states of consciousness as wakefulness, rapid eye movement (REM) sleep, or non-REM (NREM) sleep. Measures of EEG power (dB) were quantified as δ (0.5-4 Hz), θ (4-8 Hz), α (8-13 Hz), σ (12-15 Hz), β (13-30 Hz), and γ (30-60 Hz). Compared with saline (control), fentanyl and morphine decreased NREM sleep, morphine eliminated REM sleep, and buprenorphine eliminated NREM sleep and REM sleep. Opioids significantly and differentially disrupted the temporal organization of sleep/wake states, altered specific EEG frequency bands, and caused dissociated states of consciousness. The results are discussed relative to the fact that opioids, pain, and sleep modulate interacting states of consciousness.NEW & NOTEWORTHY This study discovered that antinociceptive doses of fentanyl, morphine, and buprenorphine significantly and differentially disrupt EEG-defined states of consciousness in C57BL/6J mice. These data are noteworthy because: 1) buprenorphine is commonly used in medication-assisted therapy for opioid addiction, and 2) there is evidence that disordered sleep can promote addiction relapse. The results contribute to community phenotyping efforts by making publicly available all descriptive and inferential statistics from this study (Supplemental Tables S1-S8).
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Affiliation(s)
| | | | - Zachary T Glovak
- Department of Psychology, The University of Tennessee, Knoxville, Tennessee
| | | | - Helen A Baghdoyan
- Department of Psychology, The University of Tennessee, Knoxville, Tennessee.,Oak Ridge National Laboratory, Oak Ridge, Tennessee
| | - Ralph Lydic
- Department of Psychology, The University of Tennessee, Knoxville, Tennessee.,Oak Ridge National Laboratory, Oak Ridge, Tennessee
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Mukherjee D, Stankoski DM, Tilden SE, Huhn AS, Bixler EO, Kong L, Meyer RE, Deneke E, Freet CS, Bunce SC. Reregulation of cortisol levels and sleep in patients with prescription opioid use disorder during long-term residential treatment. Drug Alcohol Depend 2021; 227:108931. [PMID: 34392049 DOI: 10.1016/j.drugalcdep.2021.108931] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 06/14/2021] [Accepted: 06/30/2021] [Indexed: 12/12/2022]
Abstract
OBJECTIVE Research has demonstrated that hypothalamic-pituitary-adrenal (HPA) axis function and sleep patterns are dysregulated in patients diagnosed with opioid use disorder (OUD). It is unclear whether and/or when cortisol and sleep might re-regulate over time, and, whether re-regulation is associated with abstinence following discharge from residential treatment. The current study evaluated changes in sleep and basal cortisol levels in prescription OUD patients in residential treatment, and the association between these measures and treatment outcome following discharge. METHOD As part of a larger study, 55 participants with prescription OUD provided two days of salivary cortisol samples and 12 consecutive nights of sleep actigraphy between days 19-30 of residential treatment (Time Point 1; TP1). Thirteen of the original 55 participants remained in residence and repeated the measures between days 60-72 (Time Point 2; TP2). Thirty-seven healthy controls (HC) provided baseline measures (TP1) of salivary cortisol and sleep. Treatment outcome data, abstinence vs relapse, were established at 120 days following discharge. RESULTS Prescription OUD patients had higher cortisol levels and lower total sleep time (TST) than HC at TP1. At TP2, TST and cortisol levels no longer differed from HCs in the subgroup of patients who remained abstinent following discharge after TP2. Individuals whose cortisol and TST did not change from TP1 to TP2 were more likely to relapse following discharge from residential treatment. CONCLUSION Re-regulation of TST and cortisol levels while in residential treatment was associated with better treatment outcome following discharge for prescription OUD patients.
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Affiliation(s)
- Dahlia Mukherjee
- Department of Psychiatry and Behavioral Health, Penn State College of Medicine, 500 University Drive, Hershey, PA, 17033, USA
| | - Dean M Stankoski
- Department of Psychiatry and Behavioral Health, Penn State College of Medicine, 500 University Drive, Hershey, PA, 17033, USA
| | - Sarah E Tilden
- Department of Psychiatry and Behavioral Health, Penn State College of Medicine, 500 University Drive, Hershey, PA, 17033, USA
| | - Andrew S Huhn
- Department of Psychiatry and Behavioral Health, Penn State College of Medicine, 500 University Drive, Hershey, PA, 17033, USA
| | - Edward O Bixler
- Department of Psychiatry and Behavioral Health, Penn State College of Medicine, 500 University Drive, Hershey, PA, 17033, USA
| | - Lan Kong
- Department of Public Health Sciences, Penn State College of Medicine, 500 University Drive, Hershey, PA, 17033, USA
| | - Roger E Meyer
- Department of Psychiatry and Behavioral Health, Penn State College of Medicine, 500 University Drive, Hershey, PA, 17033, USA
| | - Erin Deneke
- Caron Treatment Centers, 243 N Galen Hall Rd, Wernersville, PA, USA
| | - Christopher S Freet
- Department of Psychiatry and Behavioral Health, Penn State College of Medicine, 500 University Drive, Hershey, PA, 17033, USA
| | - Scott C Bunce
- Department of Psychiatry and Behavioral Health, Penn State College of Medicine, 500 University Drive, Hershey, PA, 17033, USA.
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Robinson DL, Amodeo LR, Chandler LJ, Crews FT, Ehlers CL, Gómez-A A, Healey KL, Kuhn CM, Macht VA, Marshall SA, Swartzwelder HS, Varlinskaya EI, Werner DF. The role of sex in the persistent effects of adolescent alcohol exposure on behavior and neurobiology in rodents. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2021; 160:305-340. [PMID: 34696877 DOI: 10.1016/bs.irn.2021.07.007] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Alcohol drinking is often initiated during adolescence, and this frequently escalates to binge drinking. As adolescence is also a period of dynamic neurodevelopment, preclinical evidence has highlighted that some of the consequences of binge drinking can be long lasting with deficits persisting into adulthood in a variety of cognitive-behavioral tasks. However, while the majority of preclinical work to date has been performed in male rodents, the rapid increase in binge drinking in adolescent female humans has re-emphasized the importance of addressing alcohol effects in the context of sex as a biological variable. Here we review several of the consequences of adolescent ethanol exposure in light of sex as a critical biological variable. While some alcohol-induced outcomes, such as non-social approach/avoidance behavior and sleep disruption, are generally consistent across sex, others are variable across sex, such as alcohol drinking, sensitivity to ethanol, social anxiety-like behavior, and induction of proinflammatory markers.
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Affiliation(s)
- Donita L Robinson
- Neurobiology of Adolescent Drinking in Adulthood Consortium (NADIA), United States; Bowles Center for Alcohol Studies, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States.
| | - Leslie R Amodeo
- Neurobiology of Adolescent Drinking in Adulthood Consortium (NADIA), United States; Department of Psychology, California State University, San Bernardino, CA, United States
| | - L Judson Chandler
- Neurobiology of Adolescent Drinking in Adulthood Consortium (NADIA), United States; Department of Neuroscience, Medical University of South Carolina, Charleston, SC, United States
| | - Fulton T Crews
- Neurobiology of Adolescent Drinking in Adulthood Consortium (NADIA), United States; Bowles Center for Alcohol Studies, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Cindy L Ehlers
- Neurobiology of Adolescent Drinking in Adulthood Consortium (NADIA), United States; Department of Neuroscience, Scripps Research, La Jolla, CA, United States
| | - Alexander Gómez-A
- Neurobiology of Adolescent Drinking in Adulthood Consortium (NADIA), United States; Bowles Center for Alcohol Studies, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Kati L Healey
- Neurobiology of Adolescent Drinking in Adulthood Consortium (NADIA), United States; Department of Psychiatry and Behavioral Sciences, School of Medicine, Duke University, Durham, NC, United States
| | - Cynthia M Kuhn
- Neurobiology of Adolescent Drinking in Adulthood Consortium (NADIA), United States; Department of Pharmacology and Cancer Biology, School of Medicine, Duke University, Durham, NC, United States
| | - Victoria A Macht
- Neurobiology of Adolescent Drinking in Adulthood Consortium (NADIA), United States; Bowles Center for Alcohol Studies, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - S Alexander Marshall
- Neurobiology of Adolescent Drinking in Adulthood Consortium (NADIA), United States; Biological and Biomedical Sciences Department, North Carolina Central University, Durham, NC, United States
| | - H Scott Swartzwelder
- Neurobiology of Adolescent Drinking in Adulthood Consortium (NADIA), United States; Department of Psychiatry and Behavioral Sciences, School of Medicine, Duke University, Durham, NC, United States
| | - Elena I Varlinskaya
- Neurobiology of Adolescent Drinking in Adulthood Consortium (NADIA), United States; Center for Development and Behavioral Neuroscience, Department of Psychology, Binghamton University, Binghamton, NY, United States
| | - David F Werner
- Neurobiology of Adolescent Drinking in Adulthood Consortium (NADIA), United States; Center for Development and Behavioral Neuroscience, Department of Psychology, Binghamton University, Binghamton, NY, United States
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Associations Among Sleep Disturbance, Pain Catastrophizing, and Pain Intensity for Methadone-maintained Patients With Opioid Use Disorder and Chronic Pain. Clin J Pain 2021; 36:641-647. [PMID: 32482968 DOI: 10.1097/ajp.0000000000000848] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
OBJECTIVE This study examined the cross-sectional associations among pain intensity, pain catastrophizing, and sleep disturbance among patients receiving methadone maintenance treatment (MMT) for opioid use disorder (OUD) and reporting co-occurring chronic pain. MATERIALS AND METHODS Participants were 89 individuals with OUD and chronic pain drawn from a larger cross-sectional study of 164 MMT patients who completed a battery of self-report measures. The authors conducted 6 mediation models to test all possible pathways (ie, each variable tested as an independent variable, mediator, or dependent variable). RESULTS The only significant mediation effect was an indirect effect of sleep disturbance on pain intensity through pain catastrophizing. That is, greater sleep disturbance was associated with greater pain catastrophizing, which in turn was associated with greater pain intensity. DISCUSSION Altogether, findings suggest that the sleep disturbance to pain catastrophizing to pain intensity pathway may be a key mechanistic pathway exacerbating pain issues among MMT patients with OUD and chronic pain. These results suggest that interventions targeting sleep disturbance may be warranted among MMT patients with OUD and chronic pain. Future work in this area with longitudinal data is warranted.
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Vrajová M, Šlamberová R, Hoschl C, Ovsepian SV. Methamphetamine and sleep impairments: neurobehavioral correlates and molecular mechanisms. Sleep 2021; 44:6066541. [PMID: 33406259 DOI: 10.1093/sleep/zsab001] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Revised: 11/01/2020] [Indexed: 12/12/2022] Open
Abstract
Methamphetamine is a potent and highly addictive psychostimulant, and one of the most widely used illicit drugs. Over recent years, its global usage and seizure have been on a rapid rise, with growing detrimental effects on mental and physical health, and devastating psychosocial impact pressing for intervention. Among the unwanted effects of methamphetamine, acute and long-term sleep impairments are of major concern, posing a significant therapeutic challenge, and a cause of addiction relapse. Unraveling mechanisms and functional correlates of methamphetamine-related sleep and circadian disruption are, therefore, of key relevance to translational and clinical psychiatry. In this article, we review the mounting evidence for the acute and long-term impairements of sleep-wake behavior and circadian activity caused by single or recurring methamphetamine usage and withdrawal. Factors contributing to the severity of sleep loss and related cognitive deficit, with risks of relapse are discussed. Key molecular players mediating methamphetamine-induced dopamine release and neuromodulation are considered, with wake-promoting effects in mesolimbic circuits. The effects on various sleep phases and related changes in dopamine levels in selected subcortical structures are reviewed and compared to other psychostimulants with similar action mechanisms. A critical appraisal is presented of the therapeutic use of modafinil, countering sleep, and circadian rhythm impairments. Finally, emerging knowledge gaps and methodical limitations are highlighted along with the areas for future research and therapeutic translation.
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Affiliation(s)
- Monika Vrajová
- Department of Experimental Neurobiology, National Institute of Mental Health, Klecany, Czech Republic
| | - Romana Šlamberová
- Department of Physiology, Third Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Cyril Hoschl
- Department of Experimental Neurobiology, National Institute of Mental Health, Klecany, Czech Republic.,Department of Psychiatry and Medical Psychology, Third Faculty of Medicine, Charles University, Klecany, Czech Republic
| | - Saak V Ovsepian
- Department of Experimental Neurobiology, National Institute of Mental Health, Klecany, Czech Republic.,Department of Psychiatry and Medical Psychology, Third Faculty of Medicine, Charles University, Klecany, Czech Republic
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Wilkerson AK, Simmons RO, Sahlem GL, Taylor DJ, Smith JP, Book SW, McRae-Clark AL. Sleep and substance use disorder treatment: A preliminary study of subjective and objective assessment of sleep during an intensive outpatient program. Am J Addict 2021; 30:477-484. [PMID: 34164864 PMCID: PMC8429116 DOI: 10.1111/ajad.13194] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Revised: 05/25/2021] [Accepted: 05/28/2021] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Characteristics of sleep concerns and their relationship to mental health in heterogeneous substance use disorder (SUD) treatment settings are not well understood. The purpose of this preliminary study was to assess sleep using subjective and objective measures at two time points during SUD treatment and compare sleep changes to changes in mental health measures. METHODS Treatment-seeking participants completed an assessment battery at the beginning of treatment (Time 1, N = 30) and again upon treatment completion (Time 2, approximately 4 weeks later, N = 22). The majority of participants were White (80%), male (63%), and presenting for alcohol use disorder (60.0%), though almost half reported polysubstance abuse (43%). Comorbidity was common (53%). Sleep and mental health questionnaires with 1 week of actigraphy and sleep diaries were completed at both time points. RESULTS Most participants met the criteria for a sleep disorder and mean scores on questionnaires showed poor sleep quality, insomnia symptoms, and frequent nightmares, with sleep quality and insomnia improving over time but remaining clinically significant. Nightmares did not improve. Actigraphy indicated poor sleep at both time points. Improvement in insomnia was related to improvement in measures of mental health while changes in actigraphy variables were not related to these measures. DISCUSSION AND CONCLUSIONS Multiple types of sleep disturbance are prevalent in this population, with nightmares persisting throughout treatment and insomnia symptoms showing a relationship with mental health symptoms. SCIENTIFIC SIGNIFICANCE This was the first study to longitudinally assess mental health with subjective and objective measures of sleep across multiple types of SUDs in a community SUD treatment setting.
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Affiliation(s)
- Allison K Wilkerson
- Department of Psychiatry and Behavioral Sciences, The Medical University of South Carolina (MUSC), Charleston, South Carolina, USA
| | - Richard O Simmons
- Department of Psychiatry and Behavioral Sciences, The Medical University of South Carolina (MUSC), Charleston, South Carolina, USA
| | - Gregory L Sahlem
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California, USA
| | - Daniel J Taylor
- Department of Psychology, University of Arizona, Tucson, Arizona, USA
| | - Joshua P Smith
- Department of Psychiatry and Behavioral Sciences, The Medical University of South Carolina (MUSC), Charleston, South Carolina, USA
| | - Sarah W Book
- Department of Psychiatry and Behavioral Sciences, The Medical University of South Carolina (MUSC), Charleston, South Carolina, USA
| | - Aimee L McRae-Clark
- Department of Psychiatry and Behavioral Sciences, The Medical University of South Carolina (MUSC), Charleston, South Carolina, USA
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Assessment of Subjective Sleep Problems in Men With Opioid Dependence Maintained on Buprenorphine. J Addict Med 2021; 14:132-138. [PMID: 30964756 DOI: 10.1097/adm.0000000000000539] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To assess the rates of sleep disturbances in male patients with opioid dependence maintained on buprenorphine and to assess the factors associated with sleep disturbances in this population. METHODS Observational, cross-sectional study. Male patients with opioid dependence aged 18 years and older, and started on buprenorphine at least 6 months before were screened. Those with history of comorbid psychiatric illnesses (except sleep disorders), on any other substance in high-risk category (based on WHO-Alcohol Smoking Substance Involvement Screening Test (ASSIST)), or on any other psychotropic medications (in addition to OAT with buprenorphine) were excluded. Sleep was assessed using the Pittsburgh Sleep Quality Index (PSQI), Sleep-50, and Epworth Sleepiness Scale (ESS). Each participant was interviewed in a single session lasting 60 minutes. RESULTS One hundred six participants were included. Their mean age was 41.1 (SD 14.3) years. The participants had been on OAT with buprenorphine for a median duration of 60 months (IQR 17-120), with excellent adherence rate in past 1 month. The mean current dose of buprenorphine was 10.2 (SD 3.8) mg per day. The mean subjective total sleep time was 403.5 minutes (SD 94.8) and the median sleep latency was 35 minutes (IQR 18.8-62.5). The mean PSQI score was 6.6 (SD 3.4). Nearly 63% (n = 67) participants had PSQI scores more than 5 (PSQI > 5) suggesting sleep problems. Sociodemographic, substance use, and treatment variables were compared between participants who scored more than 5 and those who scored less than 5 on PSQI. No significant difference was found between the 2 groups. CONCLUSIONS Substantial proportion of male patients with opioid dependence maintained on buprenorphine have sleep problems. The sleep problems in buprenorphine-maintained patients seem to be independent of substance use and treatment-related attributes.
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50
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Miller MB, Metrik J, McGeary JE, Borsari B, McCrae CS, Maddoux J, Arnedt JT, Merrill JE, Carey KB. Protocol for the Project SAVE randomised controlled trial examining CBT for insomnia among veterans in treatment for alcohol use disorder. BMJ Open 2021; 11:e045667. [PMID: 34103317 PMCID: PMC8190049 DOI: 10.1136/bmjopen-2020-045667] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION As many as 74% of veterans with alcohol use disorders (AUDS) report symptoms of insomnia. Insomnia represents a barrier to alcohol treatment because insomnia symptoms (1) may lead to relapse among those who use alcohol to help them sleep and may negatively impact (2) executive functions and (3) emotion regulation skills. Cognitive-behavioural therapy for insomnia (CBT-I) is an efficacious first-line treatment for insomnia; however, no research has examined the impact of CBT-I on individuals' response to alcohol treatment. In the Sleep and Alcohol for Veterans (Project SAVE) randomised controlled trial, we hypothesise that CBT-I will enhance the efficacy of alcohol treatment among Veterans with insomnia by enhancing their abilities to attend to treatment, regulate emotions and initiate sleep without alcohol. METHODS AND ANALYSIS Eighty Veterans enrolled in alcohol treatment at the Veterans Administration (VA) hospital will be randomly assigned to receive either CBT-I or single-session sleep hygiene (SH) education. Individuals will be eligible to participate if they meet Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria for moderate to severe AUD and Insomnia Disorder of at least 1-month duration. Participants will complete assessments at baseline, post-treatment and 6-week follow-up. Preliminary process outcomes include retention/recruitment rates and treatment satisfaction (feasibility and acceptability, respectively). Primary outcomes are insomnia severity, percentage of heavy-drinking days and alcohol-related problems. We will assess a variety of secondary clinical and mechanistic outcomes (eg, post-traumatic stress disorder (PTSD) symptoms, attention and working memory). ETHICS AND DISSEMINATION Ethics approval was obtained in October 2018. Data collection began in July 2019 and is planned for completion by July 2021. Trial results will be disseminated at local and national conferences, in peer-reviewed publications and through media outlets, as available. Results will also be shared with interested participants and clinical collaborators at the end of the trial. TRIAL REGISTRATION NUMBER clinicaltrials.gov identifier NCT03806491 (pre-results).
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Affiliation(s)
- Mary Beth Miller
- Department of Psychiatry, University of Missouri, Columbia, MO, USA
| | - Jane Metrik
- Center for Alcohol and Addiction Studies, Brown University, Providence, Rhode Island, USA
- Mental Health & Behavioral Sciences Service, Providence VA Medical Center, Providence, RI, USA
| | - John E McGeary
- Center for Alcohol and Addiction Studies, Brown University, Providence, Rhode Island, USA
- Mental Health & Behavioral Sciences Service, Providence VA Medical Center, Providence, RI, USA
| | - Brian Borsari
- Mental Health Service, San Francisco VA Health Care System, San Francisco, CA, USA
- Department of Psychiatry and Behavioral Services, University of California San Francisco, San Francisco, CA, USA
| | | | - John Maddoux
- Harry S Truman Memorial Veterans' Hospital, Columbia, Missouri, USA
| | - J Todd Arnedt
- Psychiatry, University of Michigan, Ann Arbor, Michigan, USA
| | - Jennifer E Merrill
- Center for Alcohol and Addiction Studies, Brown University, Providence, Rhode Island, USA
| | - Kate B Carey
- Center for Alcohol and Addiction Studies, Brown University, Providence, Rhode Island, USA
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