Insomnia, Self-Medication, and Relapse to Alcoholism

Abstract

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.

Complaints of insomnia in hospitalized alcoholics

“…[8][9][10][11] Although alcohol consumed at night usually produces somnolence thus reducing sleep latency, it has also adverse effects on sleep architecture: it fragments sleep, reducing REM and deep sleep, generating longer multiple awakenings. [12][13][14][15] The aim of this study was to determine the frequency of complaints of chronic insomnia associated with alcoholism in a population of alcoholics hospitalized for detoxification in Bogota, given its health, working, economic, and social functioning consequences.…”

Restless Sleep and Variable Sleep Timing During Late Childhood Accelerate the Onset of Alcohol and Other Drug Involvement

“…Sleep complaints among young adults increase the risk for new-onset alcohol use disorders (AUDs) or other substance use disorders (SUDs) (Breslau et al, 1996). Furthermore, once an AUD is established, sleep disturbance can predict relapse (Brower et al, 2001;Drummond et al, 1998).…”

Acute ethanol modulates glutamatergic and serotonergic phase shifts of the mouse circadian clock in vitro

“…Thus, acute ethanol disrupts normal circadian clock phase regulation, which could contribute to the physiological and psychological problems associated with alcohol abuse. Keywords suprachiasmatic nucleus; circadian rhythms; ethanol; glutamate; serotonin; brain-derived neurotrophic factorThe development of alcoholism and the likelihood of relapse drinking are associated with poor sleep quality and the deleterious effects of ethanol on sleep (Landolt and Gillin, 2001;Brower et al, 2001). Alcohol consumption reduces sleep quality (Kubota et al, 2002;Ehler and Slawecki, 2000;Landolt et al, 1996), which is closely linked to the circadian system.…”