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

Abstract

ABSTRACT. Objective: Limited prospective data indicate that premorbid sleep disturbances elevate the risk for subsequent alcohol and other drug problems, yet the implications for subsequent substance involvement trajectories remain unclear. In the present analyses, we examined risk associations between sleep characteristics during late childhood and the onset of substance use and substance use disorders into adulthood. Method: A sample of 707 children was recruited at ages 9-13 years and followed over seven additional visits through age 30 years. In 304 participants, fathers had a history of substance use disorder involving illicit drugs. Self-reported baseline sleep characteristics (restless sleep and variable sleep timing) were assessed at approximately ages 9-13 years. Assessment of alcohol, cannabis, and cocaine involvement occurred at follow-up visits. Cox proportional hazard models tested sleep characteristics as predictors of two substance-related outcomes (age at first use or diagnosis of disorder), as well as the onset of major depressive disorder. Results: Restless sleep at baseline significantly predicted an earlier onset age for trying alcohol and cannabis and showed a trend toward predicting early onset of cannabis use disorder. Restless sleep also predicted an earlier onset of depression. Irregular sleep timing at baseline significantly predicted an earlier onset age for alcohol use disorder and showed trends toward predicting early onsets of disorders of cannabis and cocaine use. Conclusions: Disturbed sleep during late childhood appears to accelerate the onset of not only initial substance use but also the development of clinically defined substance use disorder. Sleep-focused preventative efforts during late childhood may reduce the incidence of mood and substance use disorders. (J. Stud. Alcohol Drugs, 77, 649-655, 2016)

Preliminary Evidence That Real World Sleep Timing and Duration are Associated With Laboratory‐Assessed Alcohol Response

“…Growing evidence links sleep to alcohol use and alcohol‐related problems (e.g., Brower et al., ; Hasler et al., , ; Roehrs and Roth, , ; Wong et al., ). Along with sleep disturbances, many studies have reported that evening chronotypes (i.e., having a preference for later timing of sleep and activity) engage in greater alcohol use.…”

“…Notably, eveningness is often accompanied by more variable sleep timing (Soehner et al., ; Wittmann et al., ), which is also associated with alcohol involvement and thus is a hypothesized factor linking eveningness and alcohol problems (Wittmann et al., ). Cross‐sectional studies link larger weekday–weekend differences in sleep timing with greater alcohol, tobacco, and marijuana use (O'Brien and Mindell, ; Pasch et al., ), while longitudinal studies report that larger weekday–weekend differences in sleep duration predict more alcohol use disorder (AUD) symptoms 3 and 5 years later (Hasler et al., ), and greater self‐reported variability in sleep timing predicts an earlier age of onset for AUD (Hasler et al., ). Examining multiple components of sleep (e.g., self‐reported preference of sleep timing, actual sleep timing, and variability in actual sleep timing) within the same study is important to further understand which domains of sleep are most related to risk for heavy alcohol involvement.…”

Causal relationships between substance use and insomnia

“…Reversed causation -from insomnia to substance use-may also play a role. For example, adolescents with low sleep quality have shown a stronger inclination for later substance use (Hasler et al, 2016), although strong causal inferences cannot be made based on longitudinal designs.…”

Sleep Deficits and Cannabis Use Behaviors: An Analysis of Shared Genetics Using Linkage Disequilibrium Score Regression and Polygenic Risk Prediction

“…Evidence exists for the reverse relationship as well, with premorbid insomnia 21 and generalized sleep problems [39][40][41] predicting later cannabis use. This effect appears strong in early development, such that early childhood sleep deficits predict cannabis use in later adolescence 22,42-44 and sleep factors during adolescence predict adult cannabis use 21, 45 . Lastly, endorsements of an adolescent eveningness chronotype is associated with follow-up reports of increased cannabis use controlling for baseline adolescent substance use 40 .…”