Objective and self-reported sleep outcomes in people with comorbid alcohol and opioid use disorder: examining the role of gabapentin

BackgroundChronic substance use contributes to reduced sleep time and REM sleep, and increased sleep latency and WASO. These effects are exacerbated by withdrawal, impact craving, and increase risk factors for relapse to substance use.MethodsThis secondary analysis examined objective and subjective sleep data in individuals with comorbid alcohol and opioid use disorders (AUD and OUD) in an 8-week randomized, double-blind inpatient trial on gabapentin's subjective and physiological effects on oxycodone and alcohol alone, and their combination. Participants (n = 13; 8% female) were non-treatment-seeking individuals with OUD and AUD. Participants wore an ActiWatch Monitor nightly and completed daily sleep diaries. We examined the effects of gabapentin on sleep after nine laboratory sessions where oxycodone (0 mg, 15 mg, 30 mg), alcohol (placebo, 0.5 g/kg, 0.75 g/kg) and combined doses were administered and explored the relationship between baseline substance use and sleep.ResultsActive gabapentin dosing attenuated the relationship between laboratory-administered alcohol, oxycodone, and their combinations on some objective sleep measures, but not others. Self-reported heroin and alcohol use at baseline impacted sleep outcomes throughout the inpatient trial.Discussion and ConclusionGabapentin may attenuate the negative effects of opioids and alcohol on sleep, though further work is needed to examine this relationship.Scientific SignificanceSubjective and objective sleep outcomes are impacted by laboratory-administered doses of alcohol, oxycodone, and their combination, though patterns of results were somewhat inconsistent. More work is needed to understand safe and effective treatments for sleep disruption in those with OUD and AUD.