Psychotropic Substances and Sleep

Psychotropic substances may interfere in different aspects of life, routine and functionality of its users. Among the affected fields, sleep is one of the most prominent. Currently, a wide array of different substances is available in the market, acting on sleep and behavior by a multitude of mechanisms and pathways. The impact on sleep must not be treated as an isolated phenomenon in such cases, as it may be directly associated with the reinforcing properties and capability of causing dependence of these drugs. Three great classes of psychotropic substances can be defined: stimulants, depressants, and hallucinogens. Each of these has particularities that need to be considered when assessing sleep in recreational substance users. Furthermore, each substance in these classes warrants a closer look, as they may present specific traits that are crucial to the treatment of individuals with substance use disorder, such as the occult insomnia observed in cocaine users or the severe psychiatric symptoms accompanied by insomnia frequently reported during benzodiazepine abstinence. In this sense, this chapter aims to carefully evaluate each of the main classes of substances, focusing on the more recent findings regarding the relationship between their use and sleep. This body of evidence will serve as a guide to physicians and personnel from health agencies, calling attention to the decisive role sleep has in the treatment of patients with substance use disorder.