Association of Sleep Disturbance with Chronicity and Remission of Alcohol Dependence: Data from a Population‐Based Prospective Study

Crum, Rosa M.; Ford, Daniel E.; Storr, Carla L.; Chan, Ya Fen

doi:10.1097/01.alc.0000141915.56236.40

Cited by 61 publications

(53 citation statements)

References 49 publications

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“…19 Chronic dependence was more commonly associated with insomnia than no history of dependence at 13-year follow-up. 20 A recent study in adolescents found that maternal-rated sleep problems at 3 to 5 years of age (Child Behavior Checklist -Parent Version) in 257 boys from a community-recruited sample of high-risk families predicted early onset of any alcohol use by 12 to 14 years of age. This relationship was not mediated by attention problems, anxiety/depression, or aggression.…”

Section: What Are the Rates Of Co-occurrence Of Insomnia And Alcohol mentioning

confidence: 99%

Treatment Options for Sleep Disturbances During Alcohol Recovery

Arnedt

Conroy

Brower

2007

Journal of Addictive Diseases

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Sleep disturbances are extremely common in the early stages of recovery from alcohol dependence and may persist for several months despite continued abstinence. Studies indicate that sleep disturbances independently increase the risk for relapse to alcohol, suggesting that targeting these problems during recovery may support continued abstinence. However, there is limited information in the addiction literature about available and effective treatments for sleep disturbances in recovering alcoholic patients. The primary goals of this article are to describe the phenomenology of sleep disturbances during recovery from alcohol dependence, to outline the evidence linking sleep problems with alcohol relapse, and to describe available pharmacological and nonpharmacological treatment options, including the evidence regarding their efficacy in recovering alcoholic patients. Recommendations for future research are provided along with special considerations for treating insomnia in this population, including avoiding cross-dependent sedatives, such as benzodiazepines and benzodiazepine receptor agonists (BzRAs). alcohol; alcoholism; sleep; insomnia; treatment; pharmacological; nonpharmacological; cognitivebehavioral treatment Insomnia is a complaint of difficulties falling asleep, frequent and/or prolonged awakenings, and/or consistently unrefreshing sleep that occurs despite adequate sleep opportunity. Insomnia is exceedingly common: as many as 1/3 of adults report experiencing persistent insomnia symptoms during the year. [1][2][3][4] Insomnia symptoms persisting for more than one month that are associated with daytime impairment and/or psychological distress define an insomnia disorder, which occurs in one in ten individuals. Persistent insomnia is associated with wide ranging adverse consequences, including decreased quality of life, increased risk for psychiatric disturbances, increased work absenteeism, and poor interpersonal functioning. 1,2,5,6 Among patients in recovery from alcohol dependence, insomnia complaints are especially frequent and may persist for weeks to months post-abstinence. [7][8][9][10][11][12][13][14] Of particular importance, untreated insomnia may interfere with recovery from the primary alcohol addiction and contribute to relapse within the first several months of recovery. 12,15,16 Thus, treating insomnia in recovering alcoholic patients may aid in their recovery and support continued abstinence. Keywords NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author ManuscriptDespite the putative importance of sleep in the recovery process, there is limited information in the addiction literature about appropriate treatment options for insomnia during recovery. This may exist for a variety of reasons: clinicians assume that co-morbid sleep problems will remit with treatment of the primary alcohol condition; sleep problems are de-emphasized as relatively less important in the early stages of treatment for alcohol dependence; or physicians may be reluctant to address sleep problem...

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Section: What Are the Rates Of Co-occurrence Of Insomnia And Alcohol mentioning

confidence: 99%

Treatment Options for Sleep Disturbances During Alcohol Recovery

Arnedt

Conroy

Brower

2007

Journal of Addictive Diseases

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“…1,2 Individuals with chronic alcohol dependence are 2.6 times as likely to have insomnia as those without such a history. 3 However, the complex relationship between alcohol dependence and insomnia is not well understood, particularly because alcohol dependent patients often have high levels of co-morbid psychiatric and substance use disorders, which confound interpretation. [4][5][6] Many psychiatric disorders such as depression, and symptoms such as suicidal ideation, are also independently associated with insomnia.…”

Section: Introductionmentioning

confidence: 99%

Insomnia in Alcohol Dependence: Predictors of Symptoms in a Sample of Veterans Referred from Primary Care

et al. 2013

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Objective-Patients with alcohol dependence presenting for treatment may have multiple associated co-morbid conditions and limited social supports, which complicate treatment. Each of these factors has been independently associated with complaints of insomnia. In this preliminary study, we investigated the relations between insomnia complaints and socio-demographic factors and psychiatric comorbidity in treatment-seeking patients with alcohol dependence.Method-We conducted a retrospective chart review on 84 consecutive patients referred to the Behavioral Health Laboratory of the Philadelphia Veterans Affairs Medical Center for evaluation of psychiatric and substance use disorders. Patients met DSM-IV diagnostic criteria for alcohol dependence and completed a series of self-assessments of sleep. Univariate and multivariable analyses were used to examine the relations amongst the variables of interest.Results-In multivariable models, Sleep Latency was significantly greater in individuals without partners (p = .01), those with psychiatric disorders (p = .03) and smokers (p = .01), with a nonsignificant trend for those with past-year suicidal ideation. No significant predictor of Wake Time After Sleep Onset was seen. Poor Sleep Quality was predicted by younger age (OR = .93 [.88, . 98], p = .004) and the presence of a psychiatric disorder (OR = 20.80 [4, 102], p = .0002), with a non-significant trend for suicidal ideation.Conclusions-Insomnia symptoms in treatment-seeking alcohol dependent patients should prompt consideration of the individuals' psychiatric and psychosocial features.

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“…, 1997). In patients with alcohol use disorders, insomnia is often part of the withdrawal syndrome and increases risk for relapse (Crum, Ford, Storr, & Chan, 2004;Vitiello, 1997). …”

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confidence: 99%

“…A recent epidemiological study found that, in the general population, 11% of respondents reported using alcohol specifically to help them sleep (National Sleep Foundation, 2005). Alcohol consumption may initially lead to improved sleep latency, but it is ultimately associated with poorer sleep quality, early wakening, and insomnia (Crum et al, 2004;Foster & Peters, 1999). It remains unclear at this time whether chronic use of alcohol to induce sleep may result in the development of clinically significant abuse or dependence.…”

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Sleep disturbances associated with posttraumatic stress disorder and alcohol dependence

Waldrop

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Sensenig

et al. 2008

Addictive Behaviors

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Sleep disturbances commonly appear in the context of both posttraumatic stress disorder (PTSD) and alcohol use disorders. Sleep symptoms typically reported among clinical populations include delayed sleep onset, poor sleep continuity, early morning awakening, and disturbed sleep architecture. The aim of the present study was to examine multiple forms of sleep disturbances among individuals with comorbid PTSD and alcohol dependence, PTSD only, alcohol dependence only, and a control group. Both PTSD and alcohol dependence diagnoses were associated with multiple forms of sleep disturbance, but comorbidity of the two disorders did not appear to increase the risk over and above either single disorder for reporting any of the sleep difficulties examined. As PTSD symptom severity increased, so did sleep latency, mid-sleep wakening, and early morning wakening. However, contrary to our hypothesis, no significant direct relationship between severity of alcohol use and sleep disturbances was revealed. These findings suggest a need for thorough assessment of sleep symptoms in patients presenting with PTSD or alcohol dependence. Keywordsposttraumatic stress disorder; alcoholism; sleep; insomnia Sleep disturbances frequently co-occur with psychiatric disorders, including substance use disorders (SUDs) and posttraumatic stress disorder (PTSD) (Foster & Peters, 1999). Sleep symptoms typically reported among clinical populations include delayed sleep onset, poor sleep continuity, early morning awakening, and disturbed sleep architecture (Pressman & Orr, 1997). Sleep disruption can occur with acute or chronic alcohol consumption, but the pattern and severity of symptoms depends on the amount and timing of alcohol use (Vitiello, 1997). As a central nervous system depressant, alcohol can reduce sleep latency through its sedative effects. However, alcohol consumption tends to disrupt the first half of the sleep period with increases in slow wave sleep and decreases in rapid eye movement (REM) sleep. In the second half of the sleep period, even relatively low alcohol doses tend to result in increased REM sleep, more frequent episodes of wakefulness, and more frequent shifts between sleep stages (Stone, 1980). Over a number of days of consistent alcohol use near bedtime, the initial sleep Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. , 1997). In patients with alcohol use disorders, insomnia is often part of the withdrawal syndrome and increases risk for relapse (Crum, Ford, Storr, & Chan, 2004;Vitiello, 1997). NIH Public AccessThe self-medication hypothesis suggests that the high com...

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Association of Sleep Disturbance with Chronicity and Remission of Alcohol Dependence: Data from a Population‐Based Prospective Study

Cited by 61 publications

References 49 publications

Treatment Options for Sleep Disturbances During Alcohol Recovery

Treatment Options for Sleep Disturbances During Alcohol Recovery

Insomnia in Alcohol Dependence: Predictors of Symptoms in a Sample of Veterans Referred from Primary Care

Sleep disturbances associated with posttraumatic stress disorder and alcohol dependence

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