# Sleep and circadian rhythm phenotypes and mechanisms associated with opioid use disorder treatment outcomes

> **NIH NIH R01** · JOHNS HOPKINS UNIVERSITY · 2024 · $1,163,257

## Abstract

Opioid use disorder (OUD) is a rapidly escalating public health crisis with recent evidence suggesting that close
to 70% of drug overdoses involved opioids in the last year. Although many individuals seek treatment for OUD
over half return to use despite being maintained on a medication for opioid use disorder (MOUD), underscoring
the critical need to identify factors that are associated with OUD reoccurrence. Chronic opioid use has been
linked to disturbances in sleep continuity and architecture, increased risk of sleep disordered breathing (SDB),
and abnormalities in proxy measures of circadian rhythms. However, less is known about the longitudinal
association of sleep/circadian phenotypes with non-medical opioid use among individuals in OUD treatment, and
malleable pathways that may account for these associations. Such knowledge is critical to informing translational
research and the development of novel interventions aimed at improving sleep, circadian rhythms, and OUD
outcomes. The proposed observational, longitudinal study will capitalize on existing collaborations with
community-based providers to determine the association of sleep duration, sleep architecture, SDB, and proxy
measures of circadian rhythms with illicit opioid use during treatment, and potential pathways (e.g., positive and
negative affect) that may influence these relationships. Participants (N = 130) will be enrolled in buprenorphine
or methadone treatment and complete a 6-month longitudinal study wherein they will complete overnight, in-lab
polysomnography (PSG) sessions three times to assess changes over time in sleep metrics (e.g., total sleep
time, sleep architecture, SDB). Before and after PSG sessions, we will collect saliva samples from participants
to determine diurnal cortisol patterns. Participants will also be fitted with a wrist-worn actigraphy device to further
quantify sleep and circadian rest activity rhythms. At baseline and during the final week of each month of
treatment, participants will complete a week-long “data burst” that includes ecological momentary assessments
of affect, craving, and stress. Participants will complete urine toxicology screens and self-report on their drug
use at the end of each data burst. Specific aims of the study are to (Aim 1) determine the bi-directional
association of circadian RARs and diurnal cortisol patterns with non-medical opioid use, (Aim 2) investigate
whether sleep duration and architecture over the course of treatment are associated with non-medical opioid
use, and (Aim 3) examine (a) associations of MOUD use with SDB, and (b) whether SDB is associated with low
positive affect and high negative affect. We will also explore whether clinically significant sleep and circadian
rhythm phenotypes are associated with low positive affect, high negative affect, and non-medical opioid use, and
whether affective processes mediate the association of sleep/circadian rhythm phenotypes and opioid use.
Findings from this project ...

## Key facts

- **NIH application ID:** 10931450
- **Project number:** 5R01DA059473-02
- **Recipient organization:** JOHNS HOPKINS UNIVERSITY
- **Principal Investigator:** Andrew S Huhn
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $1,163,257
- **Award type:** 5
- **Project period:** 2023-09-30 → 2027-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10931450

## Citation

> US National Institutes of Health, RePORTER application 10931450, Sleep and circadian rhythm phenotypes and mechanisms associated with opioid use disorder treatment outcomes (5R01DA059473-02). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10931450. Licensed CC0.

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