Abstract
There is evidence of the reciprocal influence between the alteration of circadian rhythms and Substance Use Disorders (SUD), and part of the success of the SUD treatment lays in the patient's rhythmic recovery. We aim to elucidate the effect of the SUD treatment in circadian rhythmicity considering, for the first time, the age of onset of substance use (OSU) and duration of abstinence. We registered the sleep-wake schedules, the chronotype and the distal skin temperature of 114 SUD patients with at least 3 months of abstinence, considering whether they had begun consumption at age 16 or earlier (OSU ≤ 16, n = 56) or at 17 or later (OSU ≥ 17, n = 58), and duration of abstinence as short (SA: 3 to 5 months, n = 38), medium (MA: 6 to 9 months, n = 35) or long (LA: more than 9 months, n = 41). Moreover, we compared the patients' distal skin temperature pattern with a similar sample of healthy controls (HC, n = 103). SUD patients showed a morningness tendency and higher night values, amplitude and stability, a better adjustment to the cosine model and lower minimum temperature and circadianity index in the distal skin temperature rhythm, in contrast to the HC group. The OSU ≥ 17 and LA groups showed a more robust distal skin temperature pattern, as well as milder clinical characteristics when compared to the OSU ≤ 16 and SA groups, respectively. The circadian disturbances associated to substance consumption seem to improve with treatment, although the age of OSU and the duration of abstinence are modulating variables. Our results highlight the need to include chronobiological strategies that boost circadian rhythmicity both in SUD prevention and rehabilitation programs. The measurement of distal skin temperature rhythm, a simple and reliable procedure, could be considered an indicator of response to treatment in SUD patients.
Highlights
During adolescence there is a higher risk to begin substance consumption [1, 2], and an early age of onset of substance use (OSU) is associated to the future development of Substance Use Disorders (SUD) [3] and to more severe clinical characteristics [4,5,6,7,8]
Marital status showed higher rates of singles in the SUD group compared to higher rates of married persons in the Healthy controls volunteers (HC) group (p < 0.001), as well as higher rates of unemployed SUD patients compared to higher active workers in the HC group (p < 0.001)
The age of OSU and abstinence groups, with no significant age differences between them, had similar results to those obtained by the SUD group compared with the HC group
Summary
During adolescence there is a higher risk to begin substance consumption [1, 2], and an early age of onset of substance use (OSU) is associated to the future development of Substance Use Disorders (SUD) [3] and to more severe clinical characteristics [4,5,6,7,8]. Circadian rhythms (lasting around 24 h) deserve special attention given their relevance in both work and clinical performance They are endogenously generated by the body’s biological clock, located in the suprachiasmatic nucleus of the hypothalamus, they are synchronized with the environmental rhythm of lightdarkness [11, 12]. Several functions, both physiological (body temperature, hormone secretion, wake-sleep cycle, etc.) and psychological (mood, cognitive performance, etc.), show an evident circadian rhythmicity [10, 13,14,15]
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