Sleep Disorders and Research Center, Henry Ford Health System, Detroit, Michigan 48202, USA.
Drugs. 2009;69 Suppl 2:65-75. doi: 10.2165/11531120-000000000-00000.
Insomnia is often associated with substance dependence, with evidence suggesting that individuals seeking medical attention for sleep complaints are more likely to have drug or alcohol abuse problems than the general population. Disturbed sleep is associated with the abuse of a variety of drugs, with patients dependent on nicotine, alcohol and illicit drugs all reporting poor sleep. In addition, withdrawal from nicotine, alcohol and drugs of abuse is also associated with insomnia, and this may result in an increased risk of relapse if the sleep problems remain unresolved. Although studies suggest that the majority of pharmacological and behavioural interventions for insomnia are effective in treating sleep disturbances in dependent patients undergoing short-term drug withdrawal and short and long-term alcohol withdrawal, several questions remain unanswered. For example, little is known about the risk of relapse in abstinent drug-dependent patients experiencing withdrawal-related insomnia, the effect of insomnia treatment on nicotine withdrawal, or whether insomnia interventions prevent relapse. Participants of a workshop, held at the 6th annual meeting of The International Sleep Disorders Forum: The Art of Good Sleep in 2008, evaluated whether the effective management of sleep disorders could reduce substance dependence and the risk of relapse. Following the workshop a targeted literature review was conducted addressing this question. Data from this review that either pharmacological or cognitive behavioural treatment of insomnia could reduce the risk of relapse in substance dependence were substantially lacking. Further research is therefore required to increase our understanding of the impact of insomnia on patients with substance dependence.
失眠症通常与物质依赖有关，有证据表明，寻求医学关注睡眠问题的个体比一般人群更有可能存在药物或酒精滥用问题。睡眠障碍与各种药物的滥用有关，依赖尼古丁、酒精和非法药物的患者都报告睡眠质量差。此外，尼古丁、酒精和药物滥用的戒断也与失眠有关，如果睡眠问题仍未解决，这可能会增加复发的风险。尽管研究表明，大多数治疗失眠的药理学和行为干预措施在治疗短期药物戒断和短期及长期酒精戒断期间依赖患者的睡眠障碍方面是有效的，但仍有几个问题尚未得到解答。例如，对于正在经历戒断相关失眠的戒断药物依赖患者复发的风险、失眠治疗对尼古丁戒断的影响，或者失眠干预是否可以预防复发，人们知之甚少。2008 年在第 6 届国际睡眠障碍论坛年度会议上举办的一个研讨会的参与者评估了睡眠障碍的有效管理是否可以减少物质依赖和复发的风险。在研讨会之后，进行了一项针对该问题的目标文献综述。该综述的数据表明，药物或认知行为治疗失眠症可以降低物质依赖复发的风险，但缺乏实质性证据。因此，需要进一步研究以增加我们对失眠症对物质依赖患者的影响的理解。
