Sleep disorders substance-induced

Glassification of Substance-Related Disorders. The DSM-IV classification system (1) divides substance-related disorders into two categories (/) substance use disorders, ie, abuse and dependence and (2) substance-induced disorders, intoxication, withdrawal, delirium, persisting dementia, persisting amnestic disorder, psychotic disorder, mood disorder, anxiety disorder, sexual dysfunction, and sleep disorder. The different classes of substances addressed herein are alcohol, amphetamines, caffeine, caimabis, cocaine, hallucinogens, inhalants, nicotine, opioids, phencyclidine, sedatives, hypnotics or anxiolytics, polysubstance, and others. On the basis of their significant socioeconomic impact, alcohol, nicotine, cocaine, and opioids have been selected for discussion herein. 

The sleep disorders are categorized into primary disorders (i.e., dyssomnias and parasomnias), those related to another mental disorder, those related to a general medical disorder, and those that are substance induced. Like anxiety, disturbances of sleep affect nearly all of us at one time or another. Also like... 

Sleep disorder due to a general medical condition Substance-induced sleep disorder... 

Once chronic insomnia has developed, it hardly ever spontaneously resolves without treatment or intervention. The toll of chronic insomnia can be very high and the frustration it produces may precipitate a clinical depression or an anxiety disorder. Insomnia is also associated with decreased productivity in the workplace and more frequent use of medical services. Einally, substance abuse problems may result from the inappropriate use of alcohol or sedatives to induce sleep or caffeine and other stimulants to maintain alertness during the day. 

Benzodiazepine abuse is different from other substance abuse disorders (opiates, amphetamines, and nicotine) because benzodiazepines cause much less euphoria and do not activate the classic reward systems that are activated with other substances (mainly the mesolimbic and mesocortical dopaminergic projections). In fact, most people do not find the subjective effects of benzodiazepines pleasant beyond their therapeutic anxiolytic or sleep-inducing effects. Therefore, abuse of benzodiazepines is usually secondary to other substance-abuse disorders, with the benzodiazepine being taken for relief from symptoms induced by the use of another drug. As potential drugs of abuse, short-acting benzodiazepines seem to be preferred among addicts because of the rapidity of their onset of action (aiprazoiam, fiunitrazepam, and iorazepam). 

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