Department of Psychiatry, Perelman School of Medicine, Corporal Michael J. Crescenz VA Medical Center, MIRECC, 2nd Floor, Postal Code 116, 3900 Woodland Avenue, Philadelphia, PA 19104, USA.
Behavioral Pharmacology Research Unit, Johns Hopkins University School of Medicine, 5510 Nathan Shock Drive, Baltimore, MD 21224, USA.
Med Clin North Am. 2018 Jul;102(4):733-743. doi: 10.1016/j.mcna.2018.02.012.
Sleep and substance use disorders commonly co-occur. Insomnia is commonly associated with use and withdrawal from substances. Circadian rhythm abnormalities are being increasingly linked with psychoactive substance use. Other sleep disorders, such as sleep-related breathing disorder, should be considered in the differential diagnosis of insomnia, especially in those with opioid use or alcohol use disorder. Insomnia that is brief or occurs in the context of active substance use is best treated by promoting abstinence. A referral to a sleep medicine clinic should be considered for those with chronic insomnia or when another intrinsic sleep disorder is suspected.
睡眠和物质使用障碍通常同时存在。失眠通常与物质的使用和戒断有关。昼夜节律紊乱与精神活性物质的使用越来越相关。其他睡眠障碍,如睡眠呼吸障碍,应在失眠的鉴别诊断中考虑,特别是在使用阿片类药物或酒精使用障碍的患者中。短暂性或在物质使用背景下发生的失眠最好通过促进戒断来治疗。对于慢性失眠或怀疑存在其他内在睡眠障碍的患者,应考虑转至睡眠医学诊所。