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The association between sleep disturbance and stimulant use: A cross-lagged examination

03/2026

Journal Article

Authors:
Horigian, V. E.; Schmidt, R. D.; Feaster, D. J.; Duan, R.; Gonzalez, S. T.; Hefner, K.; Shmueli-Blumberg, D.; Vena, A.; Moran, L. M.; DiCamillo, C. A.; Shafazand, S.; Tross, S.; Feinberg, J.

Journal:
Addiction

PMID:
41833393

URL:
https://www.ncbi.nlm.nih.gov/pubmed/41833393

DOI:
10.1111/add.70400

Keywords:
random-intercept cross-lagged panel model sleep sleep disturbance sleep problems stimulant use substance use substance-related disorders

Abstract:
BACKGROUND AND AIMS: Sleep disruptions increase the risk of substance misuse. Substance use-especially stimulants-can increase acute and chronic sleep dysfunction. This study aimed to estimate the associations between sleep disturbance and stimulant use over time among participants with stimulant use disorder (StUD). DESIGN: In this secondary analysis, a Random Intercept Cross-Lagged Panel Model (RI-CLPM) was used to assess sleep disturbance and stimulant use over 8 weeks among participants with StUD. SETTING: United States of America. PARTICIPANTS: The analysis included 793 participants with StUD enrolled across 3 randomized controlled trials in the National Institute on Drug Abuse's Clinical Trials Network (CTN): CTN-0037, CTN-0048 and CTN-0068. MEASUREMENTS: Self-reported sleep disturbance was harmonized as a binary indicator across trial measures at each week. Stimulant use days per week were captured by Timeline Follow Back. Baseline covariates included age, sex, race/ethnicity, employment status, presence of depressive symptoms, any psychiatric history, treatment arm and trial. FINDINGS: Sleep disturbance was associated with a higher average number of stimulant use days the following week [beta = 0.15, 95% confidence interval (CI) = 0.09, 0.22, P < 0.001], and greater stimulant use was linked to increased odds of subsequent sleep disturbance (odds ratio = 1.20, 95% CI = 1.14, 1.26, P < 0.001). CONCLUSIONS: Higher-than-usual stimulant use appears to be associated with increased likelihood of sleep disturbance the following week, and vice versa.

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