Abstract

Introduction

Circadian dysregulation is implicated in substance use and comorbid mental health problems, but is also exacerbated by these states. In addition to conventional treatment, environmental factors (light, temperature) are potential targets for improving sleep, circadian functioning, and recovery outcomes. This study explored the feasibility of objective sleep and environmental monitoring for recovering substance users in residential treatment, and also examined the relationship between objectively measured sleep-wake rhythms and mental health outcomes.

Methods

Fifty-two (Mage=38, SD=9.6; 56% female) individuals receiving treatment for substance use were included. Environmental light exposure, temperature, and activity data were collected via wrist-worn actigraphy, and in-room sensors for a minimum of 1-week of stay within a 6-week program. Actigraphy derived sleep-wake patterns were used to calculate Interdaily Stability (IS). Data were linked to routinely collected clinical measures of mental health.

Results

No individuals opted out of the environmental monitoring aspect of the study, indicating acceptability and feasibility. Environmental loggers mounted in individual rooms recorded average nightly temperatures >21 degrees for 5/8 months. Objectively measured IS (M=.79; 95%CI=.67-.73) was negatively associated with Anxiety (r=-.33, p=.024) and Depression (r=-.36, p=.012), while sleep duration was not. Relationships between participant-level light exposure and clinical outcomes were also examined.

Discussion

Preliminary results indicate that circadian regularity appears important for mental health outcomes in this population and setting. The structured residential environment provides opportunities for regulating sleep-wake rhythms via scheduling of activities at circadian-appropriate times. This research suggests that optimising circadian- appropriate lighting and thermal comfort may lead to improved individual outcomes.

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