Psychotherapy options, albeit evidence-based and of clear clinical value, will not be discussed in this review as these are addressed elsewhere. This paper will also review potential pharmacological agents that modulate sleep. In addition, this review will discuss evidence that sleep abnormalities predict use and relapse, and that sleep abnormalities can be modulated to improve clinical outcome. This review will describe such research with regard to alcohol, cannabis, cocaine, and opioids. Understanding the sleep problems related to substance use disorders requires characterizing them both subjectively and objectively, while considering how sleep responds to periods of use and abstinence. By improving our understanding of sleep disorders that either predispose to substance use or are the result of chronic substance use, we may be better able to prevent and treat substance use disorders. This paper aims to explore and clarify the strong yet not entirely understood connection between abnormalities in sleep and substance use. Evidence also indicates that long-term abstinence from chronic substance use can reverse some sleep problems. The association between substance use and sleep problems appears to be bidirectional, with sleep problems increasing risk for developing substance use disorders, and acute and chronic substance use leading to acute and chronic problems with sleep. Nearly 70 % of patients admitted for detoxification report sleep problems prior to admission, and 80 % of those who report sleep problems relate them to their substance use. Sleep problems are commonly associated with drug and alcohol use.
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