Video: Sleep, Circadian Rhythms, and Opioid Use Disorder

Three out of four people with opioid use disorder experience sleep problems, particularly during opioid withdrawal and recovery from opioid use disorder. They sleep less well and wake frequently, the normal cycle of various sleep stages is disturbed, and their circadian rhythms, which help the body stay on a 24-hour schedule, are disrupted. As a result, they are not well rested and may feel more stress, all of which can increase risk of relapse.

Ryan Logan, Ph.D., and his team from the University of Massachusetts Chan Medical School, funded by the National Heart, Lung, and Blood Institute via the Helping to End Addiction Long-term^® Initiative, are trying to figure out how sleep and disruption of circadian rhythms contribute to opioid use disorder. Their main research question, according to Logan: “If we target sleep and circadian mechanisms on their own, can we improve treatment outcomes for people with opioid addiction?”

The team already has pinpointed specific cells in the brain’s nucleus accumbens region that both help regulate the sleep–wake cycle and drive drug seeking and relapse. They have also identified a protein called NPAS2 that modulates the cells’ response to opioids such as fentanyl and plays a role in the sleep–wake cycle as well as in circadian variations in reward and motivation.

In contrast to other researchers’ approaches, Logan’s team is starting with studies in humans and then using that information to design animal studies that can look at underlying mechanisms in more detail. For example, they want to further clarify how opioids like fentanyl affect the nucleus accumbens cells and what exact role NPAS2 plays in this process. Logan also wants to test whether strengthening NPAS2 activity can relieve fentanyl-induced sleep problems, which might help people recover from opioid use disorder. Other HEAL-funded research already has shown that for people undergoing opioid withdrawal, treatment with the sleep medication suvorexant can improve sleep, ease withdrawal, and reduce drug craving.

The NIH HEAL Initiative^® has established a dedicated research program supporting projects that investigate the role that sleep, and sleep dysfunction, have in opioid use disorder and recovery. Logan’s research is one of these projects. In addition, this program supports a variety of research endeavors ranging from basic science to clinical studies that investigate how sleep and circadian rhythms affect opioid addiction, withdrawal, relapse, and response to medication treatment but also how drug use impacts sleep health.

Watch Logan’s full interview.