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Patients with opioid use disorder (OUD) receiving opioid agonist treatment had increased sleep-wake cycle irregularity compared with age- and sex-matched healthy control participants, according to a study published in JAMA Network Open.

“Notably, among participants with OUD, greater sleep-wake irregularity was associated with longer drug use history as well as lower exposure to light,” wrote corresponding authors Rui Zhang, PhD, and Nora D. Volkow, MD, and colleagues.

The study investigated various facets of sleep and circadian disruptions in 42 patients with OUD and 31 healthy control participants. Among patients with OUD, 33 were receiving opioid agonist treatment.

Analysis of actigraphy data collected over 1 week identified greater sleep-wake irregularity in patients receiving medication for OUD compared with the nine patients with OUD who remained abstinent without medication, according to the study, and compared with healthy control participants.

“Our findings also showed that sleep-wake irregularity in OUD was not associated with employment status,” researchers reported. “Additionally, no alterations in sleep duration, physical activity, and phase time were found in participants with OUD.”

The study also explored factors and brain functions associated with sleep-wake disruptions in patients with OUD.

Greater sleep irregularity, findings showed, was associated with a longer history of opioid misuse and less exposure to daytime light. On resting-state functional MRI, patients with OUD exhibited lower fractional occupancy in the brain state dominated by default mode network activity compared with healthy control participants. Patients with more pronounced sleep-wake irregularities displayed exacerbated impairments.

Because greater daytime light exposure was associated with reduced sleep-wake disruption for patients with OUD, light therapy may help stabilize the sleep-wake cycle and provide therapeutic benefit as an adjunct to OUD medication, researchers proposed.

“These findings suggest,” they wrote, “that interventions increasing light exposure may improve sleep-wake irregularity and brain functional network dynamics in individuals with OUD receiving opioid agonist medications.”

Future longitudinal studies should investigate how different components of the sleep-wake cycle vary across periods of acute detoxification to extended abstinence and recovery, researchers advised, and which rest-activity rhythm biomarkers are sensitive to different stages of addiction.