Sleep Deficiency and Pain in Persons With Substance Use Disorders

Sleep deficiency and pain are two common conditions with the potential to complicate the care of persons with substance use disorders. Substance use disorders are commonly conceptualized as neurologically mediated compulsive and maladaptive patterns of substance use that cause problems. Acquired neurologic changes influenced by environmental and host factors such as sleep deficiency and pain can influence the varied and highly individual trajectories of substance use and have important implications for treatment. In this review, we provide an overview of sleep deficiency—a catch-all term to describe problems with various components of sleep including short sleep duration, low sleep quality, and suboptimal sleep timing (i.e., circadian abnormalities)—and pain—an unpleasant sensory and emotional experience associated with, or resembling that associated with, actual or potential tissue damage. We describe how these conditions can interact with substance use disorders, highlighting recent research findings in these areas. We also identify gaps in the literature that require further inquiry. Finally, we propose an approach to care for persons with substance use disorders and comorbid sleep deficiency and/or pain. This review explores the roles of sleep deficiency and pain in substance use disorders, providing a framework for clinicians to approach them in clinical practice.