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.

7 Reads
  • Source
    • "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. "

    Full-text · Article · Jul 2014 · Drug and Alcohol Dependence
  • Source
    • "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. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Circadian rhythms are prominent in many physiological and behavioral functions. Circadian disruptions either by environmental or molecular perturbation can have profound health consequences, including the development and progression of addiction. Both animal and humans studies indicate extensive bidirectional relationships between the circadian system and drugs of abuse. Addicted individuals display disrupted rhythms, and chronic disruption or particular chronotypes may increase the risk for substance abuse and relapse. Moreover, polymorphisms in circadian genes and an evening chronotype have been linked to mood and addiction disorders, and recent efforts suggest an association with the function of reward neurocircuitry. Animal studies are beginning to determine how altered circadian gene function results in drug-induced neuroplasticity and behaviors. Many studies suggest a critical role for circadian rhythms in reward-related pathways in the brain and indicate that drugs of abuse directly affect the central circadian pacemaker. In this review, we highlight key findings demonstrating the importance of circadian rhythms in addiction and how future studies will reveal important mechanistic insights into the involvement of circadian rhythms in drug addiction. (PsycINFO Database Record (c) 2014 APA, all rights reserved).
    Full-text · Article · Apr 2014 · Behavioral Neuroscience
  • Source
    • "Conversely, patients with genetic sleep disorders are often predisposed to addiction (Shibley et al., 2008). The most striking example, seasonal "
    [Show abstract] [Hide abstract]
    ABSTRACT: In mammals, circadian rhythms of physiology and behavior are regulated by a complex network of cellular molecular oscillators distributed throughout the brain and peripheral tissues. A master clock in the hypothalamic suprachiasmatic nuclei (SCN) synchronizes internal time with the external light-dark cycle, thus entraining the overall rhythmicity of the organism. Recent findings have challenged the dominant role of the SCN in physiological regulation and it becomes increasingly evident that close interaction between different central and peripheral clocks is necessary to maintain robust circadian rhythms of physiology and metabolism. In this review, we summarize recent findings regarding circadian organization in the SCN and in other central and peripheral tissues. We outline the communication pathways between different tissue clocks and, exemplified by the regulation of glucocorticoid release from the adrenal gland and glucose homeostasis in the blood, characterize the interaction between different clocks in the regulation of physiological processes.
    Full-text · Article · Aug 2012 · Progress in brain research
Show more