Prevalence and Correlates of Insomnia in a Polish Sample of Alcohol‐Dependent Patients

Abstract

Background Insomnia is an important symptom in alcohol‐dependent patients because it may persist despite abstinence and predispose to relapse to drinking. The goal of the present study was to evaluate the prevalence and clinical correlates of insomnia in a sample of 302 alcohol‐dependent patients admitted to treatment programs in Poland. Methods Participants were mostly men (73.8%) with a mean (SD) age of 43.5 (9.7) years. Insomnia in the past 1 month was assessed using a total score of 6 or higher on the Athens Insomnia Scale. Results Insomnia affected 62.9% of patients, and delayed sleep induction was the most common subtype. Insomnia was associated in bivariate analyses with less education, inadequate finances, problem drinking at an earlier age of onset, drinking frequency and quantity, drinking‐related consequences, severity of alcohol and nicotine dependence, psychiatric and physical severity, and a childhood history of sexual or physical abuse (p < 0.05). Logistic regression analysis showed that mental and physical health status, severity of alcohol dependence, number of drinking days in the past 3 months, and childhood abuse were independent predictors of insomnia, explaining approximately 30 to 40% of the variance. Conclusions More than 60% of alcohol‐dependent patients in a Polish sample screened positive for insomnia using a validated scale, a rate similar to those assessed with other scales in other countries. The study also showed that insomnia in alcohol‐dependent patients is associated with poor physical health and childhood abuse, similar to the general population. The multifactorial nature of insomnia in alcohol‐dependent patients has treatment implications.

Insomnia in alcohol dependent subjects is associated with greater psychosocial problem severity

“…The 75% prevalence rate of insomnia in our sample of actively drinking subjects is consistent with a range of 30-95% reported by prior studies (Baekeland, et al, 1974; Bokstrom & Balldin, 1992; Caetano, et al, 1998; Escobar-Cordoba, et al, 2009; Foster, et al, 2000; Zhabenko, et al, 2012). Reasons for varying estimates of prevalence of insomnia in prior studies include the stage of alcohol dependence of the sample, e.g., during alcohol withdrawal (Bokstrom & Balldin, 1992; Caetano, et al, 1998; Escobar-Cordoba, et al, 2009) and early recovery (Brower, et al, 2001; Foster, et al, 2000), when estimates of the prevalence of insomnia may be higher than at other times.…”

“…A recent study of alcohol-dependent subjects who were currently in treatment provided some initial data at this interface (Zhabenko, Wojnar, & Brower, 2012). Subjects with insomnia were significantly less satisfied by their current monetary situation, drank more frequently and consumed more alcoholic beverages, had higher scores on the SIP scales and total scores, had higher scores on the MAST (Michigan Alcoholism Screening Test) and lower mental and physical composite scale scores on the SF-36 (Short Form 36-item) scale, and were more likely to report a history of childhood sexual or physical abuse than alcohol dependent subjects without insomnia.…”

Measuring Sleep Disturbances in Patients With Alcohol Use Disorders

“…The discriminant/convergent validity of the SSI and the PSQI was compared by assessing their correlation with variables demonstrated in previous studies to be associated with sleep disturbance (abstainers vs users, outpatients vs inpatients, alcohol consumption quantity and frequency, sleep medication use) or not to be associated with sleep disturbance (age, sex, duration of alcohol use) (Gillin et al, 1990;Wetter and Young, 1994;Brower et al, 2001;Arnedt et al, 2007;Nenadic Sviglin et al, 2011;Zhabenko et al, 2012).…”

A Longitudinal Study of Drinking and Depression as Predictors of Insomnia in Alcohol-Dependent Individuals

“…Across 11 studies with a range from 36% to 91%, a mean of 59.4% of 3,027 AD patients endorsed symptoms of insomnia (Baekeland, Lundwall, Shanahan, & Kissin, 1974;Bokstrom & Balldin, 1992;Brower, Aldrich, Robinson, Zucker, & Greden, 2001;Caetano, Clark, & Greenfield, 1998;Cohn, Foster, & Peters, 2003;Escobar-Córdoba,Ávila-Cadavid, & Cote-Menendez, 2009;Feuerlein, 1974;Foster & Peters, 1999;Mello & Mendelson, 1970;Perney, Lehert, & Mason, 2012;Zhabenko, Wojnar, & Brower, 2012). This prevalence is comparable to insomnia rates in primary care settings (Leger, Partinen, Hirshkowitz, Chorkoverty, & Hedner, 2010;Shochat, Umphress, Israel, & Ancoli-Israel, 1999), but higher than in the general population, where approximately one-third of adults have reported one or more symptoms of insomnia in the past 6-12 months (Calem et al, 2012;Roth et al, 2006).…”

“…Well-established correlates of insomnia in AD individuals include depressive symptoms and measures of alcohol consumption, including quantity, frequency, and gamma-glutamyltransferase levels (Baekeland et al, 1974;Brower et al, 2001;Foster & Peters, 1999;Perney et al, 2012;Shinba et al, 1994;Zhabenko et al, 2012). Given the associations between drinking and insomnia, drinking and depression, and insomnia and depression, an unanswered question is whether insomnia in AD patients is better explained as a manifestation of too much drinking or depression severity.…”