Impaired Sleep in Alcohol Misusers and Dependent Alcoholics and the Impact Upon Outcome

Foster, John

doi:10.1111/j.1530-0277.1999.tb04223.x

Cited by 144 publications

(70 citation statements)

References 28 publications

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“…Consistent with other studies (8,(14)(15)(16), baseline insomnia predicted relapse to alcohol. Baseline insomnia remained a predictor of relapse even after controlling for severity of alcohol dependence and depressive symptoms.…”

Section: Discussionsupporting

confidence: 80%

“…Given that insomnia during early recovery has been linked to relapse (8,(14)(15)(16), the frequency and correlates of insomnia in alcoholics are important areas of investigation. The present study of patients with alcoholism investigated (a) the frequency and clinical correlates of insomnia, (b) the frequency of drinking to self-medicate insomnia, and (c) the relationships between insomnia, self-medication and subsequent relapse.…”

Section: Introductionmentioning

confidence: 99%

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Insomnia, Self-Medication, and Relapse to Alcoholism

Brower

Aldrich

Robinson

et al. 2001

AJP

364

305

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Objective-This study investigated the frequencies of insomnia and its self-medication with alcohol in a sample of alcoholic patients, as well as the relationship of these variables to alcoholic relapse.Method-Subjects were 172 men and women receiving treatment for alcohol dependence. They completed a sleep questionnaire, measures of alcohol problem severity and depression severity, and polysomnograpy after at least two weeks of abstinence.Results-Using eight items from the Sleep Disorders Questionnaire, >60% of subjects were classified as having symptomatic insomnia during the six months prior to treatment entry. Compared to patients without insomnia, patients with insomnia were more likely to report frequent alcohol use for sleep (55% vs. 28%; χ 2 =12.03, df=1, p=0.001), had significantly worse polysomnographic measures of sleep continuity, and had greater severity scores for both alcohol dependence and depression. Among 74 alcoholics who were followed a mean of five months after treatment, 60% with baseline insomnia vs. 30% without baseline insomnia relapsed to any use of alcohol (χ 2 =6.16, df=1, p=0.02). Insomnia remained a robust predictor of relapse after applying logistic regression analysis to control for other variables. A history of self-medicating insomnia with alcohol did not significantly predict subsequent relapse.Conclusions-The majority of alcoholic patients entering treatment reported insomnia symptoms. Given the potential link between insomnia and relapse, routine questions about sleep in clinical and research settings are warranted.

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Section: Discussionsupporting

confidence: 80%

Section: Introductionmentioning

confidence: 99%

Insomnia, Self-Medication, and Relapse to Alcoholism

Brower

Aldrich

Robinson

et al. 2001

AJP

364

305

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“…posttraumatic 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).…”

Section: Introductionmentioning

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.…”

mentioning

confidence: 99%

Sleep disturbances associated with posttraumatic stress disorder and alcohol dependence

Waldrop

Back

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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“…Disordered sleep is thought to contribute to daytime fatigue and sleepiness in alcoholics, and has been found to predict those recovering alcoholics who are at greatest risk to relapse (Gillin et al 1994;Brower et al 1998;Drummond et al 1998;Foster et al 1999). The mechanisms that account for abnormal sleep in recovering alcoholics are poorly understood.…”

Section: Introductionmentioning

confidence: 99%

Abnormal nocturnal melatonin secretion and disordered sleep in abstinent alcoholics

Kühlwein

Hauger

Irwin

2003

Biological Psychiatry

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Impaired Sleep in Alcohol Misusers and Dependent Alcoholics and the Impact Upon Outcome

Abstract: Self-reported sleep disturbance can provide clinicians with information to plan better treatment for alcohol misusers.

Cited by 144 publications

References 28 publications

Insomnia, Self-Medication, and Relapse to Alcoholism

Insomnia, Self-Medication, and Relapse to Alcoholism

Sleep disturbances associated with posttraumatic stress disorder and alcohol dependence

Abnormal nocturnal melatonin secretion and disordered sleep in abstinent alcoholics

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