Roehrs · Pharmacology, biochemistry, and behavior 2021 · narrative review · n=?

Sleep and alertness disturbance and substance use disorders: A bi-directional relation.

Cited 72 times in the scientific literature.

Level 5 - mechanism / opinion, no new human data

Narrative review without systematic methodology or quantitative synthesis.

PubMed 33582097 · doi:10.1016/j.pbb.2021.173153 · record verified 2026-08-26

What was done

Narrative review evaluating literature on how sleep and alertness disturbances influence substance use disorders across various substances and stages of addiction, focusing on the reverse direction of the commonly studied drug-to-sleep disruption pathway.

What was found

The abstract reports no numerical results or statistical findings. It concludes that sleep and alertness disturbances affect all phases of the addiction cycle, including initiation, maintenance, and relapse across a variety of substances.

Why it matters

Emphasizing sleep disturbance as an upstream contributor rather than merely a downstream consequence frames sleep management as a potential target in addiction treatment.

Limits

As a narrative review, it lacks systematic search criteria, meta-analytic pooling, and quantitative effect sizes. The abstract does not specify the specific substances reviewed, study counts, or primary participant numbers.

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