July 16, 2021

Examining an epidemic: Sleep deficiency may be exacerbating opioid use disorders

The first publication from a project funded by a $4 million award to Wayne State University to explore the connection between sleep deficiency and opioid use disorder is now available in the August issue of Translational Research, the journal of Laboratory and Clinical Medicine.

“At the intersection of sleep deficiency and opioid use: mechanisms and therapeutic opportunities,” examines the interface of sleep deficiency and opioid use, including hypothesized bidirectional associations between sleep efficiency and opioid abstinence; whether normalization of sleep deficiency might directly or indirectly improve opioid abstinence and vice versa; and possible mechanisms that could link improvements in sleep to opioid abstinence. The study team also identifies sleep-restorative therapeutic medicine approaches that should be examined in rigorous clinical trials.

Mark Greenwald, Ph.D.

Study principal investigator and Professor of Psychiatry and Behavioral Neurosciences Mark Greenwald, Ph.D., said insomnia is common in opioid addiction and is a major predictor of potential relapse. Current medications to treat insomnia have limited results on relapse and may produce unwanted side effects.

“There is a significant unmet need for interventions to improve sleep in patients with opioid use disorder, or OUD, because sleep deficiency challenges the ability of the patient to achieve and sustain drug abstinence. Sleep deficiency, which has a bidirectional relationship with opioid use, may be exacerbating the opioid epidemic,” he said.

Dr. Greenwald is the Gertrude Levin Endowed Chair in Addiction and Pain Biology, associate chair of Research and director of the department’s Substance Abuse Research Division. A team of researchers led by him in September 2019 received one of 375 grant awards across 41 states made by the National Institutes of Health in fiscal year 2019 to apply scientific solutions to reverse the national opioid crisis.

The National Heart, Lung and Blood Institute launched the “Helping to End Addiction Long-term Initiative,” or NIH HEAL Initiative, in April 2018 to improve prevention and treatment strategies for opioid misuse and addiction and to enhance pain management. The initiative still aims to improve treatments for chronic pain, curb the rates of opioid use disorder and overdose, and achieve long-term recovery from opioid addiction.

“Sleep is a basic life function, so improvement in sleep can improve quality of life because physiology is normalized and mood improves. There are several therapeutic avenues that should – and are beginning to – be studied, and our review lays out a rationale for conducting seminal controlled research in this area using medications, neuromodulation and behavioral approaches, alone or in combination,” Dr. Greenwald added.

This fall, he expects to write and submit a paper that describes the team’s clinical trial design and pragmatic adaptations due to COVID-19 that will make the trial mostly remote. They plan to publish efficacy and safety data from the trial after all participants have completed the study, likely in a couple years, he said.

The publication team included co-principal investigator and publication co-author Timothy Roehrs, Ph.D., director of research for the Henry Ford Health System’s Sleep Disorders Center, and School of Medicine M.D.-Ph.D. student Tabitha Moses.

The research was supported by the NIH HEAL Initiative grant U01 HL150551 from the National Heart, Lung and Blood Institute, the Gertrude Levin Endowed Chair in Addiction and Pain Biology, Helene Lycaki/Joe Young Sr. Funds from the Michigan Department of Health and Human Services, and the Detroit Wayne Integrated Health Network.


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