The only study available on disulfiram showed reduced REM sleep .
Acamprosate showed no/little effect on self-reported sleep but improved sleep continuity and architecture measured by polysomnography .
The two opioidergic drugs naltrexone and nalmefene had mainly detrimental effect on sleep , giving increased insomnia and /or somnolence compared with placebo , although not always significant .
The meta- analysis confirmed significantly increased somnolence and insomnia in the naltrexone group , compared with the placebo .
Overall , the currently available evidence s show more sleep problems with the opioidergic drugs ( especially naltrexone ) , while acamprosate seems to be well tolerated or even beneficial .
Acamprosate might be a more suitable choice when patients with AUD report sleep problems .
Background : Sleep disorders are commonly associated with acute and chronic use of alcohol and with abstinence .
To date , there are four approved drugs to treat alcohol use disorder ( AUD ) : disulfiram , acamprosate , naltrexone , and nalmefene .
These AUD therapies reduce the craving and risk of relapse into heavy drinking , but little is known about their effect on sleep .
As recent evidence s indicate a crucial role of sleep disorders in AUD , cl aim ing that sleep problems may trigger alcohol abuse and relapses , it is fundamental to clarify the impact of those drugs on the sleep quality of AUD patients .
This systematic review aims to answer the question : how does the pharmacotherapy for AUD affect sleep ?
Targeted Naltrexone for Early Problem Drinkers
Most published studies of the efficacy of naltrexone for alcohol treatment have focused on daily medication for relapse prevention among abstinent alcoholics . The present study compared the effects of naltrexone with those of placebo in a sample of early problem drinkers who received study medication either daily or targeted to situations identified by the patients as being high risk for heavy drinking . Patients ( n = 153 ; 58 % male ) were r and omly assigned to receive naltrexone ( 50 mg ) or placebo on a daily or targeted basis , yielding comparable numbers of patients in each of four treatment groups . Patients were trained to use structured nightly diaries in which they recorded their alcohol consumption and medication intake . Analysis was conducted with hierarchical linear modeling . Irrespective of whether they received naltrexone or placebo , patients in the targeted condition showed a reduced likelihood of any drinking . There was a reduced likelihood of heavy drinking , both for patients who received naltrexone and for patients who were in the targeted groups ( either naltrexone or placebo ) , although these effects diminished as the number of tablets available to the targeted groups was reduced over the 8-week treatment period . Although the effect was a modest one , daily naltrexone reduced the risk of heavy drinking in this patient group . Furthermore , use of a targeted approach to medication treatment appears to be a useful strategy for reducing both drinking and heavy drinking . Efforts to replicate these findings are warranted , since they suggest that schedules of medication administration other than daily should be evaluated for treatment of problem drinking
The only study available on disulfiram showed reduced REM sleep .
Acamprosate showed no/little effect on self-reported sleep but improved sleep continuity and architecture measured by polysomnography .
The two opioidergic drugs naltrexone and nalmefene had mainly detrimental effect on sleep , giving increased insomnia and /or somnolence compared with placebo , although not always significant .
The meta- analysis confirmed significantly increased somnolence and insomnia in the naltrexone group , compared with the placebo .
Overall , the currently available evidence s show more sleep problems with the opioidergic drugs ( especially naltrexone ) , while acamprosate seems to be well tolerated or even beneficial .
Acamprosate might be a more suitable choice when patients with AUD report sleep problems .
Background : Sleep disorders are commonly associated with acute and chronic use of alcohol and with abstinence .
To date , there are four approved drugs to treat alcohol use disorder ( AUD ) : disulfiram , acamprosate , naltrexone , and nalmefene .
These AUD therapies reduce the craving and risk of relapse into heavy drinking , but little is known about their effect on sleep .
As recent evidence s indicate a crucial role of sleep disorders in AUD , cl aim ing that sleep problems may trigger alcohol abuse and relapses , it is fundamental to clarify the impact of those drugs on the sleep quality of AUD patients .
This systematic review aims to answer the question : how does the pharmacotherapy for AUD affect sleep ?