Sleep Dysfunction as a Core Feature of Opioid Use Disorder and Recovery


The Research Need

Over 75 percent of people with opioid use disorder (OUD) have sleep problems, such as having irregular sleep schedules and not sleeping well or long enough. Sleep affects many mechanisms that are involved in opioid misuse, including reward and reinforcement, mood regulation, stress, risk-taking behavior, and pain perception.

Sleep deficiency has many effects beyond sleepiness, including alteration of attention, emotion, and memory processes at the cellular level. Getting inadequate sleep reduces the ability of brain cells to function properly and makes coping with the stress of OUD more difficult. It is important to learn whether sleep deficiency contributes to the overuse of opioids and addiction, and how individuals respond to medication treatments to overcome addiction.

About the Program

This program will support basic and clinical research to identify the behavioral and molecular mechanisms that directly connect sleep to the biological underpinnings of OUD. It will include research on how sleep and circadian rhythms are related to opioid addiction, withdrawal, relapse, and response to medication treatment. More research is needed to explore these mechanisms as potential therapeutic targets in the prevention and treatment of opioid addiction.

Some of the research will involve experimental models of sleep and circadian deficiency and OUD, including behavioral, pharmacological, and genetic models. Researchers will use an array of approaches — such as in vivo, in vitro, genomic, imaging, pharmacologic, and computational strategies — to study behavioral, physiological, molecular, genetic, and pharmacological mechanisms that combine sleep and OUD.

This program will help researchers improve existing treatments for OUD and point the way to new therapies.

Program Details

To date, through the Helping to End Addiction Long-termSM Initiative, or NIH HEAL InitiativeSM, NIH has awarded eight grants in this area, including grants for basic mechanistic studies and clinical trial research. The awarded grants total approximately $24.9 million. The projects will use various models and methods to understand the relationship between OUD and sleep deficiency to improve outcomes for people with OUD.

Research Examples

Examples of research to be undertaken include:

  • Examining how sleep deficiency affects the risk of relapse in individuals treated for OUD and whether interventions to improve sleep problems lead to better OUD treatment outcomes.
  • Studying how sleep problems trigger mechanisms in the brain that increase the risk of opioid misuse.
  • Investigating the mechanisms that connect sleep disturbance to OUD, including stress, mood, craving, pain, and addiction liability.
  • Identifying potential therapeutic targets to improve sleep in OUD and to counteract the effects of sleep disturbance on opiate misuse, addiction, and relapse.

  • Johns Hopkins University – Maryland
  • Medical College of Wisconsin – Wisconsin
  • Pennsylvania State University Hershey Medical Center – Pennsylvania  
  • SRI International – California
  • Stanford University – California
  • University of Pittsburgh – Pennsylvania
  • Wayne State University – Michigan
  • Yale University – Connecticut

Funded Projects

Use of a GLP-1 Agonist to Treat Opioid Use Disorder in Rats and Man
Sep 29, 2020
Transitions Clinic Network: Post Incarceration Addiction Treatment, Healthcare, and Social Support (TCN PATHS) study
Sep 29, 2020
Sleep, opiate withdrawal and the N/OFQ - NOP system
Mar 19, 2020
The Collaboration Linking Opioid Use Disorder and Sleep ("CLOUDS") Study
Mar 19, 2020
Dual-orexin antagonism as a mechanism for improving sleep and drug abstinence in opioid use disorder
Mar 19, 2020

Closed Funding Opportunities

Notice of Special Interest (NOSI): NHLBI and NIDA Announce Availability of Administrative Supplements for HEAL Awardees to Address Sleep Impairments in OUD Treatment Response and Recovery Outcomes
Mar 27, 2020