At the intersection of sleep deficiency and opioid use: mechanisms and therapeutic opportunities

Abstract

Due to the ongoing opioid epidemic, innovative scientific perspectives and approaches are urgently needed to reduce the unprecedented personal and societal burdens of nonmedical and recreational opioid use. One promising opportunity is to focus on the relationship between sleep deficiency and opioid use. In this review, we examine empirical evidence: (1) at the interface of sleep deficiency and opioid use, including hypothesized bidirectional associations between sleep efficiency and opioid abstinence; (2) as to whether normalization of sleep deficiency might directly or indirectly improve opioid abstinence (and vice versa); and (3) regarding mechanisms that could link improvements in sleep to opioid abstinence. Based on available data, we identify candidate sleep-restorative therapeutic approaches that should be examined in rigorous clinical trials.

Figure 1.

Conceptual model, illustrating hypothesized bidirectional relationships of sleep deficiency (focus of this review), and other salient factors (pain states, negative mood/stressors, physiological mediators), with opioid craving and/or use.