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 in alcoholism: proposal of a simple measurement, and results from a 24-week randomized controlled study of alcohol-dependent patients assessing acamprosate efficacy.
AIMS Sleep disturbance symptom ( SDS ) is commonly reported in alcoholic patients . Polysomnography studies suggested that acamprosate decreased SDS . We assessed this hypothesis by using data of a r and omized controlled trial . As a secondary objective , we suggested and tested the validity of a simple measurement of SDS based on the Hamilton depression and anxiety inventory subset . METHODS We re-analysed a multi-center study evaluating the efficacy of acamprosate compared with placebos on alcohol-dependent patients in concentrating on SDS change in time . The Sleep sum score index ( SAEI ) was built from check-lists on adverse effects reported at each visit and constituted our main endpoint . We also tested the validity of the short sleep index ( SSI ) defined by the four sleep items of the Hamilton depression and anxiety scales . Statistical analyses were conducted on an intention to treat basis . RESULTS A total of 592 patients were included , and 292 completed the 6-month trial . Compared with SAEI considered as our reference , the observed specificity and sensitivity of SSI were 91.6 and 87.6 % . From 40.2 % of patients experiencing SDS at baseline , this proportion decreased until 26.1 % at M6 in the placebo group and 19.5 % in the acamprosate group ( relative risk placebo/acamprosate = 1.49 , 95 % confidence interval 1.10 , 1.98 , P = 0.04 ) . CONCLUSION Treating alcoholic patients to enhance abstinence has a beneficial effect in reducing SDS , and the duration of abstinence during the treatment constitutes the main positive factor . An additional effect of acamprosate is conjectured from its effect on the glutamatergic tone . The SSI constitutes a simple , reasonably sensitive and specific instrument tool to measure SDS
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 ?