Sleep‐Disordered Breathing in Alcoholics

Abstract

Sleep apnea and related disorders contribute to disturbed sleep in abstinent alcoholics. In an earlier report from our group, sleep-disordered breathing was common and increased with age in a cohort of 75 abstinent alcoholics. We now report an extension of the previous work that includes studies of an additional 103 abstinent alcoholics undergoing treatment for alcoholism (total sample = 188) and a comparison group of 87 normal subjects. The presence and severity of sleep-disordered breathing was assessed with polysomnography. Among the alcoholics, sleep-disordered breathing (defined as 10 or more apneas plus hypopneas per hour of sleep) was present in 3% of 91 subjects under age 40, 17% of 83 subjects age 40 to 59, and 50% of 14 subjects age 60 or over. Subjects with sleep-disordered breathing were more likely to be male and had more severe sleep disruption and nocturnal hypoxemia and more complaints related to daytime sleepiness than subjects without sleep-disordered breathing. In a multiple linear regression analysis, age and body mass index were significant predictors of the presence of sleep-disordered breathing, whereas smoking history and duration of heavy drinking were not predictors after controlling for the effects of age and body mass index. Our findings suggest that sleep-disordered breathing contributes significantly to sleep disturbance in a substantial proportion of older alcoholics and that symptomatic sleep-disordered breathing increases with age in alcoholics. Sleep-disordered breathing, when combined with existing cardiovascular risk factors, may contribute to adverse health consequences in alcoholics.

The Comorbidity of Sleep Apnea and Mood, Anxiety, and Substance Use Disorders among Obese Military Veterans within the Veterans Health Administration

“…This is consistent with previous research conducted among veterans, 20 however, is in contrast to a host of additional work suggesting an association between substance use disorders and sleep apnea. 40,41 This finding may be influenced by data collection methods. This is to say, all data were collected from outpatient VA records.…”

Insomnia, Self-Medication, and Relapse to Alcoholism

“…Third, only 43% of patients were followed over time. The low follow-up rate reflects the fact that longitudinal outcomes were added as a secondary area of interest after starting our primary investigations on the effects of alcoholism and aging on sleep abnormalities (17). It is true that followed and not followed patients did not differ on any baseline variables except depression and WASO; and when these two variables were entered into the logistic regression analysis, insomnia remained a robust predictor of relapse.…”

“…Subjects with DSM-III-R diagnoses of alcohol dependence were recruited to participate in a study examining the effects of aging and alcoholism on sleep (17). Because six patients had missing data on critical sleep items as described below, the sample size for data analyses was reduced from 178 to 172.…”

Effects of age and alcoholism on sleep: a controlled study.

“…Recently sober alcoholics (who have been abstinent for 2 to 4 wk) also manifest differences in the sleep EEG when compared to non-alcoholic controls (Aldrich et al, 1999;Benca et al, 1992;Gillin et al 1990b;Le Bon et al, 1997;Snyder and Karacan 1985;Williams and Rundell, 1981). As with older adults, total sleep time, sleep efficiency, and delta sleep are generally decreased, whereas stage 1 sleep is usually increased (Aldrich, 1998;Le Bon et al 1997).…”