Abstract
Aims. Sleep disturbances are common in addiction and withdrawal. This study examined the course of sleep quality in a population of alcohol dependent patients during qualified detoxification treatment in a psychiatric hospital. Methods. The Pittsburgh Sleep Quality Index (PSQI) was administered to 77 electively admitted alcohol dependent patients hospitalized for qualified detoxification treatment. Sleep quality was measured at admission and at discharge. Results. The prevalence of bad sleep as measured by a PSQI-score > 5 was 70.1% at admission. During detoxification, male and female patients were equally affected by sleep disturbances and improvement of sleep was not significantly different between males and females. The PSQI score at admission predicted the change of the PSQI score during qualified detoxification treatment. After inpatient detoxification, sleep disturbances persisted in 59.7% of the patients. Conclusions. Contrary to our expectations, the average patient's sleep quality improved in our study after two weeks of detoxification treatment. Sleep disturbances nevertheless persisted in almost two-thirds of the patients. In the view of that finding, patients may require individual evaluation of sleep quality and insomnia-specific treatment in the course of detoxification therapy.
Highlights
The aetiology of sleep disturbances in addiction seems bidirectional
Male and female patients were affected by sleep disturbances and improvement of sleep was not significantly different between males and females
Repeated administration of substances of abuse can alter the homeostatic balance of neurotransmitters such as acetylcholine [3], dopamine, glutamate [4, 5], GABA [6], norepinephrine [7], and hypocretin/orexin [8] which leads to tolerance and contributes to the development of dependence
Summary
The aetiology of sleep disturbances in addiction seems bidirectional. Research has shown that sleep disturbances experienced early in life predispose an individual to develop a substance use disorder [1] while in turn substance abuse contributes to sleep problems [2]. Sleep disturbances are common among people with substance use disorders [10]. Insomnia is highly prevalent in patients with addiction during active use of the substance [11]. 70 % of the patients were admitted for detoxification report sleep problems prior to admission [14]. It is not surprising that sleep problems are extremely common in early alcohol recovery [16]. Individuals with alcohol dependence frequently report poor quality of sleep [17, 18]. Prolonged abstinence from alcohol leads to sleep fragmentation, a higher level of arousal during sleep, and an increase in the amount of REM sleep [19, 20]
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