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 ?
Sleep disturbance and risk for alcohol-related problems.
OBJECTIVE Using prospect i ve data , the authors assessed the risk of alcohol-related problems among individuals with self-reported sleep disturbances because of worry . METHOD As part of the Epidemiologic Catchment Area program , a probability sample of Baltimore residents selected by census tracts and households completed a baseline interview in 1981 . Between 1993 and 1996 , the original Baltimore cohort was traced . Of the 2,633 survivors , a total of 73 % were reinterviewed . After excluding individuals with alcohol-related problems or a current or prior history of alcohol abuse and /or dependence at the time of the 1981 interview , the authors identified a cohort of 1,537 individuals who were at risk for problem drinking at the time of the follow-up interview , a median of 12.6 years after the baseline interview .  Logistic regression was used to assess the association between sleep disturbance because of worry and the risk for incident reports of alcohol problems . RESULTS Survey respondents with sleep disturbances because of worry  at the time of the baseline interview had a twofold higher risk for developing an alcohol-related problem , relative to those without these sleep disturbances ( odds ratio=2.32 , 95 % confidence interval [CI]=1.31 - 4.09 ) , with adjustment for selected demographic and clinical variables . Sleep disturbance because of worry predicted the development of alcohol problems among respondents with lifetime anxiety disorders and lifetime dysphoria ( odds ratio=3.82 , 95 % CI=1.56 - 9.38 , and odds ratio=2.71 , 95 % CI=1.25 - 5.91 , respectively ) , but not among those without a history of anxiety disorders or dysphoria . CONCLUSIONS Sleep disturbances because of worry may increase risk for alcohol-related problems . Risk is highest for those with sleep disturbance and co-occurring anxiety disorders or dysphoria
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 ?