Insomnia in personality disorders and substance use disorders
Introduction
Insomnia is an important health issue [1], afflicting around 10% of the general population [2]. It is associated with daily cognitive impairments (e.g., memory/attention deficits) [3] and higher rates of depression and anxiety [4]. The DSM-5 [5] defines insomnia as a difficulty in initiating or maintaining sleep which is present at least three times a week in the past three months based on subjective reports [5]. It can present itself alone or in comorbidity with another health disorder (mental, physical, or sleep-related). This paper will focus on insomnia in comorbidity with personality disorders and substance use disorders since research in these particular areas has surged in recent years.
Section snippets
Comorbidity between PDs and insomnia
A growing field of research focuses on the relationship between insomnia and PDs. Studies show that 50% to 93% of individuals with a PD experience at least one sleep problem or self-identify as insomnia sufferers [6,7,8]. Conversely, more than 50% of individuals with insomnia received at least one PD diagnosis [9•]. These findings indicate that, while individuals with a PD are more likely to present sleep disturbances, individuals with insomnia may be at higher risk for exhibiting maladaptive
Comorbidity between SUD and insomnia
Systematic and narrative literature reviews indicate that the use of substances and sleep disorders share a bidirectional relationship [27, 28, 29]. Insomnia can be present before substance dependence or abuse, or be associated with withdrawal (lasting for weeks) and relapse [27]. In their literature review, Grau-López et al. [30] reported that in studies recruiting patients with a SUD, the prevalence of insomnia ranges from 30% to 85% depending on the primary substance of abuse. Conversely,
Conclusion
Only a paucity of research exists in the field of personality disorders and insomnia. The relationship between substance use disorder and insomnia, in contrast, has received more attention. Although the study of objective sleep is not recommended for the diagnosis of insomnia, this approach has highlighted peculiarities in the sleep of individuals with a PD or a SUD. For instance, individuals with a BPD present increased sleep onset latency and lower sleep efficiency. Importantly, emotion
Conflict of interest statement
Nothing declared.
References and recommended reading
Papers of particular interest, published within the period of review, have been highlighted as:
• of special interest
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