Sleep as a Modifiable Risk Factor for Progression to Substance Use Disorder: A Review of Applicability in Adolescents with Early Life Adversity

Substance use disorder (SUD) often originates in childhood and adolescence, with early life adversity (ELA) being a particularly potent risk factor increasing susceptibility. This narrative review explores the intricate relationships between ELA, sleep disturbances, and substance use in adolescents. We identified relevant articles through a PubMed search of keywords (ELA, sleep, substance use, adolescents), focusing on peer-reviewed research and reviews from the past three years, supplemented by reference list reviews and prior exposure based on previous work in the area.

We examine psychological and neurobiological processes underlying ELA-induced sleep disturbances and substance use, as well as the bidirectional relationship between sleep and substance use. We also discuss the efficacy of sleep-focused interventions in improving mental health and reducing substance use, noting untested potential in ELA-exposed youth.

By focusing on core but less studied pathways underlying substance use behaviors, such as internalizing psychopathology and subcortical circuits, future research can pave the way for innovative new interventions to significantly impact life trajectories in this vulnerable population.