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 ?
A multicentre, randomized, double-blind, placebo-controlled trial of naltrexone in the treatment of alcohol dependence or abuse.
The opioid antagonist , naltrexone , is reported , in single centre studies , to improve the clinical outcome of individuals with alcohol dependence participating in outpatient psychosocial programmes . This is the first multicentre controlled study to evaluate the efficacy and safety of naltrexone as adjunctive treatment for alcohol dependence or abuse . Patients who met criteria for alcohol dependence ( n = 169 ) or alcohol abuse ( n = 6 ) were r and omly assigned to receive double-blind oral naltrexone 50 mg daily ( n = 90 ) or placebo ( n = 85 ) for 12 weeks as an adjunct to psychosocial treatment . The primary efficacy variable was time to first episode of heavy drinking ; secondary efficacy assessment s included time to first drink , alcohol consumption , craving , and changes in the serum biological markers gamma-glutamyl transferase ( GGT ) , and aspartate and alanine aminotransferases . Compliance was assessed by tablet counts and , in the naltrexone-treated group , by measurement of urinary concentrations of 6-ss-naltrexol . Forty-nine ( 58 % ) patients r and omized to placebo and 53 ( 59 % ) r and omized to naltrexone  did not complete the study . In intention-to-treat analyses , there was no difference between groups on measures of drinking . The median reduction from baseline of serum GGT ( P : < 0.05 ) and the reductions in alcohol craving ( Obsessive and Compulsive Drinking Scale : OCDS ) were greater in the naltrexone group ( P : < 0.05 ) , from approximately half-way through the study . Of 70 patients ( 35 placebo ; 35 naltrexone ) who met an a priori definition of compliance ( 80 % tablet consumption , attendance at all follow-up appointments ) , those allocated to naltrexone reported consuming half the amount of alcohol ( P : < 0.05 ) , had greater median reduction in serum GGT activity ( P : < 0.05 ) , and greater reduction in alcohol craving ( OCDS total score : P : < 0.05 ; Obsessive subscale score : P : < 0.05 ) , compared to patients in the placebo group . Use of naltrexone raised no safety concerns . Naltrexone is effective in treating alcohol dependence/abuse in conjunction with psychosocial therapy , in patients who comply with treatment
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 ?