Abstract
A high percentage of subjects diagnosed with alcohol use disorder (AUD) suffer from sleeping difficulties. Lack of sleep could lead AUD patients to relapse or, sometimes, to suicide. Most of the currently prescribed medications to treat this complex problem retain a high risk of side effects and/or dependence. Therefore, the aim of the current clinical trial is to investigate the possibility of the use of a safer treatment, such as the natural health product melatonin, to treat alcohol-related sleeping problems. Sixty treatment-seeking AUD subjects were assigned to melatonin (5 mg) or placebo for 4 weeks of treatment. Change in sleeping quality which is the primary outcome of the study was assessed using the Pittsburgh sleep quality index (PSQI) scale. Linear mixed models were used to statistically analyze the difference in scores before and after 4 weeks of treatment. There was a reduction in the global PSQI score in both groups with no significant drug effect between groups. In conclusion, the use of melatonin (5 mg)/day didn’t differ from placebo in decreasing sleeping problems in a sample of AUD subjects after 4 weeks of treatment. However, higher doses are worth exploring in future research.
Highlights
Over 70% of subjects diagnosed with alcohol use disorder (AUD) suffer from alcohol- induced sleep problems and some studies suggest that the percentage could reach up to 91%1,2
When alcohol effects wear off, AUD subjects experience an increase in sleep latency, or the time taken to fall asleep, with a decrease in total sleep duration,; this may represent a mechanism by which tolerance to the hypnotic effects of alcohol could be explained[8]
The Alcohol use disorder identification test (AUDIT) score at baseline was 25.83 (±8.37)
Summary
Over 70% of subjects diagnosed with alcohol use disorder (AUD) suffer from alcohol- induced sleep problems and some studies suggest that the percentage could reach up to 91%1,2. When alcohol effects wear off, AUD subjects experience an increase in sleep latency, or the time taken to fall asleep, with a decrease in total sleep duration, (circadian rhythm sleep-wake disorder); this may represent a mechanism by which tolerance to the hypnotic effects of alcohol could be explained[8]. No matter how successful AUD treatments are, the persistence of disturbed sleep represents a huge barrier to successful long term abstinence[19] It is not unusual for benzodiazepine receptor agonist medications to be prescribed to treat sleeping problems. Despite their well-known efficiency, benzodiazepine use is associated with impaired cognitive and psychomotor skills, increased risk of falls, dependence and abuse[14]. There is a real need for a safer treatment for sleeping problems, especially among patients suffering from substance use disorder (SUD)[4]
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