Feasibility of continuous sleep and environmental monitoring in residential substance use recovery: Associations with mental health outcomes

AI Summary

Continuous unobtrusive monitoring of sleep and bedroom environment is feasible for many residential treatment residents, though adherence varied across prolonged actigraphy and questionnaires.
Higher subjective pre-sleep arousal was positively associated with greater depressive, anxiety and post-traumatic stress symptoms.
Objective sleep regularity and earlier timing related to fewer post-traumatic stress and anxiety symptoms; sleep duration showed no association with mental health variables.

Drug Alcohol Depend. 2026 May 1;284:113181. doi: 10.1016/j.drugalcdep.2026.113181. Online ahead of print.

ABSTRACT

INTRODUCTION: Quality sleep is important for substance use recovery. Supporting and monitoring sleep during residential treatment poses challenges, but unobtrusive technologies like actigraphy or environmental sensors offer objective low burden measurement. We examined the feasibility and acceptability of these technologies, and associations between sleep and mental health outcomes.

METHODS: This pilot and feasibility study employed a naturalistic design. Fifty-two adults in residential treatment for diverse substance-related issues wore actigraphs and completed daily sleep diaries over a period of up to 4 weeks during live-in treatment. Subjective assessments of pre-sleep arousal and sleep quality were collected alongside routine clinical measures at study entry and exit. Environmental sensors continuously recorded sleep environment (temperature, light) data.

RESULTS: Of the 52 participants, thirty-three participants wore actigraphs for > 14 days; 23 completed exit questionnaires, and 11 interviews. Significant positive associations were found between subjective pre-sleep arousal and symptoms of depression, anxiety, and post-traumatic stress. Objective sleep regularity was negatively associated with post-traumatic stress, anxiety, and pre-sleep somatic arousal. Later sleep midpoint was linked to greater subjective sleep disturbance and anxiety. Objective sleep duration was not associated with any mental health variables.

DISCUSSION: Continuous, unobtrusive monitoring of sleep and bedroom environments is feasible in residential settings for many residents, though feasibility varied across longer-term actigraphy monitoring and questionnaire completion. This approach may offer a first step in identifying targets for future interventions to improve sleep and support recovery.

PMID:42119197 | DOI:10.1016/j.drugalcdep.2026.113181

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