Sleep disturbance is a prominent and common complaint in people with cocaine use disorder (CUD), either during intake or withdrawal. Repetitive transcranial magnetic stimulation (rTMS) has shown promise as a treatment for CUD. Thus, we evaluated the relationship between self-perceived sleep quality and cocaine use pattern variables in outpatients with CUD undergoing an rTMS protocol targeted at the left dorsolateral prefrontal cortex. This is a retrospective observational study including 87 patients diagnosed with CUD according to the DSM-5 criteria. Scores in Pittsburgh Sleep Quality Index (PSQI), Cocaine Craving Questionnaire (CCQ), Beck Depression Inventory-II (BDI-II), Self-rating Anxiety Scale (SAS), and Symptoms checklist 90-Revised (outcome used: Global Severity Index, GSI) were recorded at baseline, and after 5, 30, 60, and 90 days of rTMS treatment. Cocaine use was assessed by self-report and regular urine screens. Sleep disturbances (PSQI scores > 5) were common in patients at baseline (mean ± SD; PSQI score baseline: 9.24 ± 3.89; PSQI > 5 in 88.5% of patients). PSQI scores significantly improved after rTMS treatment (PSQI score Day 90: 6.12 ± 3.32). Significant and consistent improvements were also seen in craving and in negative-affect symptoms compared to baseline. Considering the lack of a control group, in order to help the conceptualization of the outcomes, we compared the results to a wait-list group (n = 10). No significant improvements were observed in the wait-list group in any of the outcome measures. The present findings support the therapeutic role of rTMS interventions for reducing cocaine use and accompanying symptoms such as sleep disturbance and negative-affect symptoms. ClinicalTrials.gov.NCT03733821.

中文翻译：

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回顾性观察性研究表明，在可卡因使用障碍患者中，经反复经颅磁刺激（rTMS）治疗期间，睡眠质量得到改善。

在摄入或戒断期间，睡眠障碍是可卡因使用障碍（CUD）患者的常见突出症状。重复经颅磁刺激（rTMS）已显示出有望作为CUD的治疗方法。因此，我们评估了接受针对左背外侧前额叶皮层的rTMS协议的门诊患者的自我感觉睡眠质量与可卡因使用模式变量之间的关系。这是一项回顾性观察性研究，其中包括根据DSM-5标准诊断为CUD的87例患者。匹兹堡睡眠质量指数（PSQI），可卡因渴望调查表（CCQ），贝克抑郁量表II（BDI-II），自评焦虑量表（SAS）和症状清单的得分90修订（使用过的结果：全球严重程度指数） （GSI）记录在基线，然后在5、30、60，和90天的rTMS治疗。通过自我报告和定期尿液筛查评估可卡因的使用。基线时患者常见睡眠障碍（PSQI评分> 5）（平均值±SD； PSQI评分基线：9.24±3.89； 88.5％的患者PSQI> 5）。rTMS治疗后PSQI评分显着改善（第90天的PSQI评分：6.12±3.32）。与基线相比，渴望和负面影响症状也得到了显着且持续的改善。考虑到缺少对照组，为了帮助将结果概念化，我们将结果与候补名单组（n = 10）进行了比较。在任何结果指标中，等待名单组均未观察到明显改善。本研究结果支持rTMS干预措施在减少可卡因使用和伴随症状（如睡眠障碍和负面影响症状）方面的治疗作用。ClinicalTrials.gov.NCT03733821。