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 ?
Efficacy of As-Needed Nalmefene in Alcohol-Dependent Patients with at Least a High Drinking Risk Level: Results from a Subgroup Analysis of Two Randomized Controlled 6-Month Studies
Aims : The aim of the study was to investigate the efficacy and safety of as-needed use of nalmefene 18 mg versus placebo in reducing alcohol consumption in patients who did not reduce their alcohol consumption after an initial assessment , i.e. the pooled subgroup of patients with at least a high drinking risk level ( men : > 60 g/day ; women : > 40 g/day ) at both screening and r and omization from the two r and omized controlled 6-month studies ESENSE 1 ( NCT00811720 ) and ESENSE 2 ( NCT00812461 ) . Methods : Nalmefene 18 mg and placebo were taken on an as-needed basis . All the patients also received a motivational and adherence-enhancing intervention ( BRENDA ) . The co- primary outcomes were number of heavy drinking days ( HDDs ) and mean total alcohol consumption ( g/day ) in Month 6 measured using the Timeline Follow-back method . Additionally , data on clinical improvement , liver function and safety were collected throughout the study . Results : The pooled population consisted of 667 patients : placebo n = 332 ; nalmefene  n = 335 . There was a superior effect of nalmefene compared with placebo in reducing the number of HDDs [ treatment difference : −3.2 days ( 95 % CI : −4.8 ; −1.6 ) ; P < 0.0001 ] and total alcohol consumption [ treatment difference : −14.3 g/day ( −20.8 ; −7.8 ) ; P < 0.0001 ] at Month 6 . Improvements in clinical status and liver parameters were greater in the nalmefene group compared with the placebo group . Adverse events and adverse events leading to dropout were more common with nalmefene than placebo . Conclusion : As-needed nalmefene was efficacious in reducing alcohol consumption in patients with at least a high drinking risk level at both screening and r and omization , and the effect in this subgroup was larger than in the total population
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 ?