Abstract

Cocaine-use disorders are associated with profound abnormalities in sleep and sleep architecture. With continued abstinence from cocaine, polysomnographically measured sleep reaches insomnia-like levels. However, chronic cocaine users experience their sleep as improving as abstinence continues. This dissociation between the self-reported sleep experience and polysomnographically measured sleep has been termed “occult insomnia.” This insomnia of abstinence and the associated abnormalities in sleep architecture may contribute to poor cognitive performance, to mood dysregulation, and to worse clinical outcomes. Treatments that address the objective sleep abnormalities associated with abstinence may help promote better outcomes.

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