Disturbed Sleep and Its Relationship to Alcohol Use

Stein, Michael D.; Friedmann, Peter D.

doi:10.1300/j465v26n01_01

Cited by 240 publications

(196 citation statements)

References 87 publications

(107 reference statements)

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“…This finding is in contrast with a wealth of literature stating that, as people age, their sleep worsens. 42,43 Alcohol intake did not account for this relationship in this sample, which is unexpected, given the close relationship between alcohol and sleep, 55 and the fact that most people in our sample were regular drinkers. Rather, our post hoc analyses revealed that, once PTSD symptoms were added to the regression model, the significant relationship between age and sleep went away.…”

Section: Discussionmentioning

confidence: 60%

“…Future studies should also include both drinkers and non-drinkers given the known relationship between alcohol and sleep. 55 An additional important limitation is that PHQ item-3 assesses both insomnia and hypersomnia and we only validated it against an insomnia instrument. It remains to be seen to what extent false positives are related to endorsing the PHQ sleep item due to hypersomnia and whether these may Figure 1.…”

Section: Discussionmentioning

confidence: 99%

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Evaluation of the PHQ-9 Item 3 as a Screen for Sleep Disturbance in Primary Care

et al. 2011

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Section: Discussionmentioning

confidence: 60%

Section: Discussionmentioning

confidence: 99%

Evaluation of the PHQ-9 Item 3 as a Screen for Sleep Disturbance in Primary Care

et al. 2011

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“…However, severe and long-lasting insomnia-related sleep disruption reliably appears during acute alcohol withdrawal (Vitiello, 1997). Perhaps in a sample with a greater range of alcohol use severity and chronicity and repeated measures over time, a different pattern would emerge (Rundell, Williams, & Lester, 1977;Stein & Friedmann, 2006). These results highlight the need for more thorough assessment of sleep disruption in patients who present with PTSD.…”

Section: Discussionmentioning

confidence: 97%

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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“…13,14 Findings across several studies demonstrate a relation between alcohol use and sleep problems. Mechanisms that contribute to this relation may be bidirectional; alcohol use contributes to sleep disturbances, 15,16 and sleep disturbances may contribute to alcohol use. For example, Brower and colleagues looked at sleep problems and alcohol use in 172 individuals receiving treatment for alcohol dependence and found that 60% of participants with insomnia symptoms relapsed to alcohol use in the months following treatment, compared to 30% of participants without insomnia symptoms.…”

Section: 10mentioning

confidence: 99%

Explaining Alcohol Use and Suicide Risk: A Moderated Mediation Model Involving Insomnia Symptoms and Gender

Nadorff

Salem

Winer

et al. 2014

Journal of Clinical Sleep Medicine

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Study Objectives: The purpose of the study was to examine whether insomnia symptoms and nightmares mediated the relation between alcohol use and suicide risk. Further, we examined whether this mediation was moderated by gender. Design: The study consisted of questionnaires administered online examining insomnia symptoms, nightmares, alcohol use, and suicide risk. Setting: University. Patients or Participants: 375 undergraduate students at a large, public university in the southeastern United States. Interventions: N/A. Measurements and Results: Results indicated that insomnia symptoms signifi cantly mediated the relation between alcohol use and suicide risk; however, this mediation was moderated by gender. For women, there was both a direct effect of alcohol use on suicide risk as well as an indirect effect of alcohol use through insomnia symptoms increasing suicide risk. For men, there was no direct effect of alcohol use on suicide risk, but there was a signifi cant indirect effect of alcohol use increasing suicide risk through insomnia symptoms. Nightmares were not related to alcohol use, and the association between nightmares and suicide risk was found to be independent of alcohol use Conclusions: Insomnia symptoms are an important factor in explaining the mechanism by which alcohol use increases suicide risk. Keywords: insomnia symptoms, suicide risk, alcohol use, gender Citation: Nadorff MR, Salem T, Winer ES, Lamis DA, Nazem S, Berman ME. Explaining alcohol use and suicide risk: a moderated mediation model involving insomnia symptoms and gender. J Clin Sleep Med 2014;10(12):1317-1323.pii: jc-00186-14 http://dx.doi.org/10.5664/jcsm.4288 S C I E N T I F I C I N V E S T I G A T I O N SS uicide is a serious and growing public health concern in the United States (U.S.). In 2010 alone, 38,364 Americans died by suicide, making suicide the tenth leading cause of death in the U.S.; among 15-24 year olds it was the third leading cause of death, and was the second leading cause of death among college-age students.1 Moreover, 2010 marked the fi fth consecutive year that suicide rates in the U.S. increased.1 Thus, it is crucial for clinicians and researchers to gain a better understanding of suicide risk and protective factors. Insomnia and Suicide RiskNumerous empirical studies have demonstrated a relation between insomnia symptoms and suicide risk, 2-7 including several that have found an association above and beyond other psychopathology. In a longitudinal study of 6,504 adolescents, Wong and Brower found that sleep problems signifi cantly predicted future suicidal ideation and attempts. 7 Additionally, among young adults in the military, insomnia symptoms were positively related to suicidal ideation. 6 Insomnia symptoms are also associated with death by suicide. In a chart review of U.S. Veterans who died by suicide, Pigeon and colleagues found that Veterans who had documented insomnia symptoms died within a shorter time span following their last VA appointment than did Veterans who had not reported insomnia sympto...

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Disturbed Sleep and Its Relationship to Alcohol Use

Cited by 240 publications

References 87 publications

Evaluation of the PHQ-9 Item 3 as a Screen for Sleep Disturbance in Primary Care

Evaluation of the PHQ-9 Item 3 as a Screen for Sleep Disturbance in Primary Care

Sleep disturbances associated with posttraumatic stress disorder and alcohol dependence

Explaining Alcohol Use and Suicide Risk: A Moderated Mediation Model Involving Insomnia Symptoms and Gender

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