Correlates of polysomnographic sleep changes in cocaine dependence: self-administration and clinical outcomes.

Abstract

BACKGROUND:

Abstinence from chronic cocaine use is associated with abnormal sleep architecture. As sleep abnormalities are associated with clinical outcome in alcohol dependence, we hypothesized a similar relationship in cocaine dependence.

METHODS:

We report data from a cocaine self-administration study (N=12) and the placebo arm of a randomized clinical trial (N=20). Self-administration participants underwent three cocaine self-administration sessions during a three-week inpatient stay. Treatment participants underwent two weeks of inpatient followed by six weeks of outpatient treatment including once-weekly cognitive behavioral therapy. Measurements included polysomnography from early and late in abstinence during the inpatient stays. Clinical outcomes included amount of cocaine self-administered, urine tests, and self-reported use and withdrawal symptoms.

RESULTS:

Change in slow-wave sleep from early to late abstinence (ΔSWS; p=0.05), late abstinence rapid eye movement sleep (REM; p=0.002), and late abstinence total sleep time (p=0.02) were negatively correlated with the amount of cocaine self-administered. Early abstinence REM was positively correlated with withdrawal symptoms (p=0.02). Late abstinence REM was positively correlated with percent negative urines and maximum consecutive number of days abstinent (both p<0.001). ΔSWS was positively correlated with percent negative urines (p=0.03) and participants with increased SWS had greater percent negative urines (p=0.008) and maximum consecutive number of days abstinent (p=0.009).

CONCLUSIONS:

Correlations between sleep deficits and amount of cocaine self-administered, clinical outcomes, and severity of withdrawal symptoms underscore the relevance of sleep in clinical outcomes in the treatment of cocaine dependence.

• Authors: Gustavo A Angarita, Sofija V Canavan, Erica Forselius, Andrew Bessette, Peter T Morgan
• Journal: Drug and alcohol dependence (Drug Alcohol Depend) Vol. 143 Pg. 173-80 (Oct 01 2014) ISSN: 1879-0046 [Electronic] Ireland
• PMID: 25124303 (Publication Type: Journal Article, Randomized Controlled Trial, Research Support, N.I.H., Extramural)
• Copyright: Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Chemical References

• Anesthetics, Local
• Cocaine

Topics

• Adult
• Anesthetics, Local (adverse effects, pharmacology)
• Cocaine (adverse effects, pharmacology)
• Cocaine-Related Disorders (physiopathology, psychology, rehabilitation)
• Cognitive Behavioral Therapy
• Dose-Response Relationship, Drug
• Female
• Humans
• Male
• Middle Aged
• Polysomnography (drug effects)
• Self Administration
• Sleep Wake Disorders (chemically induced, physiopathology)
• Substance Abuse Detection
• Substance Withdrawal Syndrome (physiopathology, psychology)