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 ?
Morphine effects on human REM state, waking state and NREM sleep
Summary After 4 adaptation nights , IM doses of morphine sulfate ( 7.5 , 15 , 30 mg/70 kg ) and placebo were studied in 8 male postaddicts , using a cross-over design with r and omized block analysis to demonstrate significant drug effect . Morphine decreased the number and duration of REM periods , delayed the onset of the first REM period , and possibly increased the time between REM period onsets . Thus , morphine significantly decreased REM state ( REMS ) , but did not alter the pattern of maximum REMS in late night . Morphine significantly increased waking state ( WS ) but did not alter the pattern of maximum WS in early night . Morphine significantly increased tension , and shifted maximum tension from early night to middle night . Morphine altered EEG sleep patterns ; although NREM definitions were thus less certain , morphine appeared to increase NREM light sleep ( stages 1 and 2 ) and decrease NREM deep sleep ( stages 3 and 4 ) . After an initial decrease in REMS by 30 mg/70 kg of morphine , an increase in REMS was noted in the third night of the 2 pilot study subjects . The arousal response to morphine seen in post-addicts needs further study in other population s and during the course of chronic morphine use
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 ?