Alcohol Dependence and Its Relationship With Insomnia and Other Sleep Disorders

Chakravorty, Subhajit; Chaudhary, Ninad S.; Brower, Kirk J.

doi:10.1111/acer.13217

Cited by 184 publications

(143 citation statements)

References 124 publications

(131 reference statements)

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“…For example, participants in these studies were not necessarily seeking or engaged in treatment for alcohol use, and they varied in rates of abstinence at baseline. Rates of alcohol relapse may be higher among those in earlier recovery (2 to 4 weeks after detoxification), which is a time of prevalent sleep disturbance (Chakravorty, Chaudhary, et al, 2016). As such, findings may not generalize to those in earlier recovery or those actively seeking treatment.…”

Section: Discussionmentioning

confidence: 99%

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Insomnia treatment in the context of alcohol use disorder: A systematic review and meta-analysis

Miller

Donahue

Carey

et al. 2017

Drug and Alcohol Dependence

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Purpose To determine the efficacy of behavioral and pharmacological interventions for insomnia among individuals with alcohol use disorder (AUD). Procedures Comprehensive literature searches of psychological, medical, and educational databases were conducted through October 2016. Eligible studies evaluated the efficacy of an insomnia intervention, included a comparison condition, sampled individuals with AUD and either insomnia disorder or complaints of insomnia, assessed sleep-related outcomes, and provided relevant statistics to calculate between-group effect sizes. Effect sizes were estimated for sleep quality, days of alcohol abstinence, and symptoms of depression. Type of intervention (behavioral versus pharmacological) was tested as a moderator of intervention efficacy. Main Findings Nine studies met eligibility criteria and were included in the final review and meta-analysis. Random-effects models indicated that intervention participants reported greater improvements in sleep quality (d+ =0.62, 95%CI= 0.28, 0.97) and symptoms of depression (d+ =0.52, 95%CI= 0.06, 0.98) than control participants. Participants reported significantly greater improvements in sleep quality in response to behavioral (d+ =1.20, 95%CI= 0.70, 1.70) as opposed to pharmacological (d+ =0.43, 95%CI= 0.19, 0.67) interventions. Behavioral (d+ =0.74, 95%CI= 0.31, 1.18) and pharmacological (d+ =0.08, 95%CI= −0.64, 0.78) interventions did not have significantly different effects on depressive symptoms. Neither behavioral nor pharmacological interventions improved rates of alcohol abstinence. Conclusions Insomnia interventions improve sleep quality and reduce symptoms of depression among individuals with comorbid AUD. Given the methodological weaknesses of studies reviewed, additional research is needed to determine the efficacy of insomnia treatment in improving rates of alcohol relapse within this population.

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Section: Discussionmentioning

confidence: 99%

“…Recent reviews have summarized the clinical manifestations, etiology, assessment, and treatment of insomnia in the context of AUD (Brooks and Wallen, 2014; Brower, 2015; Chakravorty, Chaudhary, et al, 2016). However, none have quantified the impact of various insomnia treatments on sleep- and alcohol-related outcomes.…”

Section: Introductionmentioning

confidence: 99%

Insomnia treatment in the context of alcohol use disorder: A systematic review and meta-analysis

Miller

Donahue

Carey

et al. 2017

Drug and Alcohol Dependence

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“…Alcohol’s effect on another oscillatory region, the lateral geniculate nucleus (LGN) of the thalamus has also been studied in this monkey model (Breckinridge Carden et al, 2006). The LGN regulates sleep/wake cycles, arguably one of the most critical daily rhythms that is disrupted in subjects with AUDs (see Chakravorty et al, 2016 for review). Burst firing within the LGN was significantly dampened following long-term alcohol consumption in cynomolgus males (Breckinridge Carden et al, 2006), providing a possible cellular basis for understanding, and treating, alcohol induced sleep disruption.…”

Section: Iii: Consequences Of Heavy Drinking On Stress Systemsmentioning

confidence: 99%

Studies using macaque monkeys to address excessive alcohol drinking and stress interactions

Jiménez

Grant

2017

Neuropharmacology

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The use of non-human primates (NHPs) in studies of volitional, oral self-administration of alcohol can help address the complex interplay between stress and excessive alcohol consumption. There are aspects to brain, endocrine and behavior of NHPs, particularly macaques, that provide a critical translational link towards understanding the risks and consequences of alcohol use disorders (AUDs) in humans. These include wide individual differences in escalating daily alcohol intake, accurate measures of hypothalamic-pituitary-adrenal (HPA) axis hormonal interactions, neuroanatomical specificity of synaptic adaptations to chronic alcohol, genetic similarities to humans, and the ability to conduct in vivo brain imaging. When placed in a framework that alcohol addiction is a sequence of dysregulations in motivational circuitry associated with severity of AUD, the NHP can provide within-subject information on both risks for and consequences of repeatedly drinking to intoxication. Notably, long-term adaptations in neurocircuitry that mediate behavioral reinforcement, stress responses and executive functions are possible with NHPs. We review here the substantial progress made using NHPs to address the complex relationship between alcohol and stress as risk factors and consequences of daily drinking to intoxication. This review also highlights areas where future studies of brain and HPA axis adaptations are needed to better understand the mechanisms involved in stress leading to excessive alcohol consumption.

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“…Taken together, alcohol dependence is associated with significant sleep disturbances (Chakravorty, Chaudhary, & Brower, ), which are often accompanied by abnormal thalamus dysfunction (Li et al, ). The thalamus plays an essential role in the dorsal relay of the brainstem reticular activating system, controlling cortical activation that occurs during wakefulness and REM sleep (Thakkar, Sharma, & Sahota, ).…”

Section: Introductionmentioning

confidence: 99%

Reduced resting‐state functional connectivity and sleep impairment in abstinent male alcohol‐dependent patients

Liu

Cai

Zhao

et al. 2019

Human Brain Mapping

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Alcohol dependence is associated with poor sleep quality, which has both been implicated with thalamocortical circuits function. To identify the possible roles of these circuits in the alcohol‐sleep association, we investigated the volume of both left and right thalamus and corresponding resting‐state functional connectivity (RSFC) differences between 15 alcohol‐dependent patients (AD) and 15 healthy controls (HC) male participants. The neuroimaging findings were then correlated with clinical variables, that is, Alcohol Use Disorders Identification Test (AUDIT) and Pittsburgh Sleep Quality Index (PSQI). Additionally, mediation analysis was carried out to test whether the thalamocortical RSFC mediates the relationship between drinking behavior and sleep impairments in AD when applicable. We observed a significant positive correlation between AUDIT score and PSQI score in AD. Compared with HC, AD showed reduced RSFC between the left thalamus and medial prefrontal cortex (mPFC), orbitofrontal cortex, anterior cingulate cortex (ACC), and right caudate. We also observed a negative correlation between RSFC of the left thalamus–mPFC and PSQI score in AD. More importantly, the left thalamus–mPFC RSFC strength mediated the relationship between AUDIT score and PSQI score in AD. No significant difference was detected in the normalized volume of both left and right thalamus, and volumes were not significantly correlated with clinical variables. Our results demonstrate that AD show abnormal interactions within thalamocortical circuits in association with drinking behaviors and sleep impairments. It is hoped that our study focusing on thalamocortical circuits could provide new information on potential novel therapeutic targets for treatment of sleep impairment in alcohol‐dependent patients.

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Alcohol Dependence and Its Relationship With Insomnia and Other Sleep Disorders

Cited by 184 publications

References 124 publications

Insomnia treatment in the context of alcohol use disorder: A systematic review and meta-analysis

Insomnia treatment in the context of alcohol use disorder: A systematic review and meta-analysis

Studies using macaque monkeys to address excessive alcohol drinking and stress interactions

Reduced resting‐state functional connectivity and sleep impairment in abstinent male alcohol‐dependent patients

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