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 double-blind, placebo-controlled study of oral nalmefene for alcohol dependence.
BACKGROUND Nalmefene is a newer opioid antagonist that is structurally similar to naltrexone but with a number of potential pharmacological advantages for the treatment of alcohol dependence , including no dose-dependent association with toxic effects to the liver , greater oral bioavailability , longer duration of antagonist action , and more competitive binding with opioid receptor subtypes that are thought to reinforce drinking . METHODS A double-blind , placebo-controlled trial was conducted to evaluate the safety and efficacy of 2 doses of oral nalmefene for alcohol dependence . The 105 outpatient volunteers were abstinent for a mean of 2 weeks prior to r and om assignment to the placebo or 20- or 80-mg/d dose nalmefene groups for 12 weeks . Cognitive behavioral therapy was provided weekly during treatment . Self-reported drinking or abstinence was confirmed by determinations of breath alcohol concentration and by collateral informant reports . RESULTS Outcomes did not differ between the 20- and 80-mg dose nalmefene groups . Significantly fewer patients treated with nalmefene than patients given placebo  relapsed to heavy drinking through 12 weeks of treatment ( P<.02 ) , with a significant treatment effect at the first weekly study visit ( P<.02 ) . The odds ratio of relapsing to heavy drinking was 2.4 times greater with placebo compared with nalmefene ( 95 % confidence interval , 1.05 - 5.59 ) . Patients treated with nalmefene also had fewer subsequent relapses ( P<.03 ) than patients given placebo . CONCLUSIONS Treatment with nalmefene was effective in preventing relapse to heavy drinking relative to placebo in alcohol-dependent out patients and was accompanied by acceptable side effects
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 ?