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Sleep Disturbances Linked to Substance Use Disorders: Meta-Analysis

Publication Title: Sleep alterations in substance use disorders: a systematic review and meta-analysis

Summary

Question
This study aimed to investigate how different substance use disorders (SUDs), such as alcohol (AUD), nicotine (NUD), cocaine (CoUD), opioids (OUD), and cannabis (CaUD), affect sleep patterns. The researchers systematically reviewed and analyzed data to identify specific sleep disruptions linked to each substance and compared objective measures (e.g., total sleep time) with subjective assessments (e.g., self-reported sleep quality).
Why it Matters
Sleep disturbances are common in individuals with SUDs and can persist even after they stop using substances, potentially increasing the risk of relapse and hindering recovery. Understanding how different substances affect sleep can guide the development of targeted interventions to improve sleep quality and support recovery. These findings are relevant to healthcare providers, researchers, and individuals seeking better outcomes in SUD treatment.
Methods
The researchers conducted a systematic review and meta-analysis of 43 studies involving approximately 7,500 participants. They analyzed data from both subjective sleep assessments, such as the Pittsburgh Sleep Quality Index (PSQI), and objective measures, such as polysomnography (a detailed sleep study). Studies focused on adults with specific SUDs and included control groups for comparison.
Key Findings
The study found that sleep disruptions vary by substance. AUD, NUD, and OUD were linked to shorter total sleep time and poorer subjective sleep quality. AUD also showed reduced slow-wave sleep (a deep, restorative sleep stage). CoUD was associated with poorer sleep quality and reduced slow-wave sleep but not with total sleep time. Limited data on CaUD suggested poorer sleep, but the findings were inconclusive. Benzodiazepine (BUD) and methamphetamine (MUD) use lacked sufficient data for analysis.
Implications
These findings highlight the importance of addressing sleep issues in SUD treatment. Poor sleep quality may serve as a modifiable risk factor for relapse. Tailored interventions, such as sleep-focused therapies and substance-specific treatments, could improve recovery outcomes. For example, medications like modafinil (for CoUD) and suvorexant (for OUD) or non-pharmacological approaches like cognitive behavioral therapy for insomnia could be beneficial.
Next Steps
The authors suggest further research to explore sex-specific differences in sleep disruptions, long-term changes in sleep patterns during recovery, and the effectiveness of targeted sleep interventions. They also recommend investigating underrepresented substances, such as benzodiazepines and methamphetamines, and expanding the use of accessible sleep measurement tools like actigraphy.
Funding Information
This research was supported by the National Institute on Drug Abuse (NIDA) grants R01 DA052454-03, R33DA053592, R01DA060231-01, and R13MH132238. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Full Citation

Oliva H, Prudente T, Naveda A, Monteiro-Junior R, Potenza M, Morgan P, Angarita G. Sleep alterations in substance use disorders: a systematic review and meta-analysis. EClinicalMedicine 2026, 91: 103723. PMID: 41552000, PMCID: PMC12805338, DOI: 10.1016/j.eclinm.2025.103723.
This AI-assisted summary has been reviewed and approved by at least one of the study's authors to ensure it accurately reflects the research.

Authors

  • Henrique Oliva, MD, PhD

    First Author
    Yale School of Medicine

    Associate Research Scientist of Psychiatry

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  • Gustavo A. Angarita, MD, MHS

    Last Author
    Yale School of Medicine

    Assistant Professor of Psychiatry

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Additional Yale School of Medicine Authors

Other Authors

  • Alisson M. Paredes Naveda;
  • Renato Sobral Monteiro-Junior

Research Themes

Concepts