Abstract
Background: Sleep problems are particularly frequent in psychiatric disorders, but their bidirectional intersection is poorly clarified. An especial link between substance use and sleep seems to exist. While dual disorder patients are certainly at higher risk of experiencing sleep problems, very limited research is available today. Methods: Forty-seven dual disorder hospitalized patients were included in this first study. A complete psychiatric evaluation was performed, and sleep habits, patterns and potential disorders were evaluated with specific sleep scales, as well as anxiety. Results: The global prevalence of insomnia symptoms was considerably higher compared with the general population. Different abuse patterns as a function of concurrent psychiatric diagnosis were found, with no significant gender differences. The association between the investigated sleep parameters and any specific substance of abuse was minor. The addict behavior started in more than half of the patients prior to the main psychiatric diagnosis and close to the beginning of sleep problems. Men had a higher prevalence of insomnia symptoms, together with a higher incidence of anxiety. Overall, subjective daytime functioning was not altered as a consequence of poor sleep. Conclusion: Dual disorder patients face significant sleep disturbances, with low sleep quality. The role of sleep in addiction and dual disorders deserves greater research.
Highlights
Sleep problems are especially frequent in psychiatric disorders, but their complex bidirectional interactions are still poorly understood and, several common neurobiological abnormalities may explain why sleep disorders are related to the risk of developing different psychiatric disorders, the causal relationships have not been clearly identified [1,2]
Similar findings were described by Breslau et al in a longitudinal epidemiological study of young adults [6], while Xue Gao et al suggested the causal role of insomnia in autism spectrum disorder and bipolar disorder [2] and Acker et al stated the relevance of psychiatric comorbidities in the treatment of patients with obstructive sleep apnea syndrome, focusing their research on depression [7]
It has long been known that sleep problems are more prevalent among persons with use of or dependence on substances and that those with sleep problems have a higher risk of developing substance use problems than the general population [5,8]
Summary
Sleep problems are especially frequent in psychiatric disorders, but their complex bidirectional interactions are still poorly understood and, several common neurobiological abnormalities may explain why sleep disorders are related to the risk of developing different psychiatric disorders, the causal relationships have not been clearly identified [1,2]. A cross-sectional (six-month) association between sleep disturbances and major depression, anxiety disorders and substance use disorders is reported in this study. Similar findings were described by Breslau et al in a longitudinal epidemiological study of young adults [6], while Xue Gao et al suggested the causal role of insomnia in autism spectrum disorder and bipolar disorder [2] and Acker et al stated the relevance of psychiatric comorbidities in the treatment of patients with obstructive sleep apnea syndrome, focusing their research on depression [7]. While dual disorder patients are certainly at higher risk of experiencing sleep problems, very limited research is available today. The role of sleep in addiction and dual disorders deserves greater research
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