Adolescents with Insomnia and Substance Abuse: Consequences and Comorbidities

Medical University of South Carolina, Charleston, SC, USA.
Journal of psychiatric practice 05/2008; 14(3):146-53. DOI: 10.1097/01.pra.0000320113.30811.46
Source: PubMed


Adolescents have high rates of sleep disorders and substance abuse, both of which have been associated with deleterious effects on mood, attention, and behavior. This article reviews data on the prevalence of sleep disorders, substance abuse problems, and comorbid psychiatric conditions in the adolescent population. Studies have consistently demonstrated that the prevalence of sleep problems is under-reported in adolescents in both clinical and community samples. The bidirectional correlation between substance use and sleep disturbances is also discussed. Based on the findings presented here, the authors conclude that it is imperative to improve the detection and treatment of sleep problems in children and adolescents. By treating sleep disturbances and targeting poor sleepers with additional counseling and education regarding the risk of substance use, clinicians may be able to prevent or delay the adverse effects of addiction. At the very least, the presence of insomnia should alert clinicians to the need for further evaluation for drug and alcohol abuse.

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    • "However, the similarity of the findings between the two studies – a laboratory-controlled self-administration study and a treatment study – as well as prior studies showing a potential role of sleepiness in the reinforcing and subjective effects of stimulants (Roehrs et al., 2004) and previously demonstrated effects of poor sleep on factors such as cognition, mood, and impulsivity, support the likelihood that there is a causal relationship between sleep and cocaine use in chronic cocaine users. This interpretation of the data is also supported by similar findings relating sleep to alcohol use (Allen et al., 1975, 1977; Benca et al., 1992; Brower and Hall, 2001; Brower, 2003; Colrain et al., 2009), and by longitudinal studies that suggest a " bi-directionality " in the relationship between sleep and substance use (Pasch et al., 2012; Shibley et al., 2008). To determine whether sleep architectural changes contribute causally to treatment outcome, present and future studies will examine the effect of normalization of sleep (e.g., with modafinil; Morgan et al., 2010) on clinical outcomes. "
    Drug and Alcohol Dependence 07/2014; 140:e5. DOI:10.1016/j.drugalcdep.2014.02.036 · 3.42 Impact Factor
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    • "Thus it appears that vulnerability to addiction is dependent on the circadian system in multiple ways. Once an individual starts abusing drugs or alcohol, this exposure produces both acute and lasting changes to circadian rhythms and sleep, creating a vicious cycle for someone who already started with a circadian rhythm abnormality (Irwin, Valladares, Motivala, Thayer, & Ehlers, 2006; Jones, Knutson, & Haines, 2003; Morgan et al., 2006; Shibley, Malcolm, & Veatch, 2008; Wasielewski & Holloway, 2001). These changes to rhythms and sleep persist even after administration of the abused substance has stopped, and this very often contributes to relapse. "
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