Literature DB >> 17117964

Perception of sleep in recovering alcohol-dependent patients with insomnia: relationship with future drinking.

Deirdre A Conroy1, J Todd Arnedt, Kirk J Brower, Stephen Strobbe, Flavia Consens, Robert Hoffmann, Roseanne Armitage.   

Abstract

BACKGROUND: Subjective and objective measures of poor sleep in alcoholic insomniacs predict relapse to drinking. Nonalcoholic insomniacs underestimate their total sleep time (TST) and overestimate their sleep onset latency (SOL) and wake time after sleep onset (WASO) compared with polysomnography (PSG). This study evaluated 3 hypotheses: (1) subjective SOL would predict frequency of future drinking; (2) participants would overestimate SOL and WASO and underestimate TST; and (3) higher amounts of over- and underestimates of sleep at baseline would predict worse drinking outcomes prospectively.
METHODS: Participants (N=18), mean age 44.6 years (+/-13.2), underwent an adaptation night and then 2 nights of PSG 3 weeks apart. They also provided morning estimates of SOL, WASO, TST, and sleep efficiency (SE). Following the baseline PSG, participants were followed over 12 weeks. A 2-way ANOVA (night x method of measuring sleep) compared results and regression analyses predicted drinking. Drinking outcomes were defined as number of days drinking (DD) and number of heavy-drinking days (HDD) during 2 consecutive 6-week follow-up periods.
RESULTS: Most participants (72%) overestimated SOL by a mean of 21.3 (+/-36) minutes compared with PSG [F(1, 14)=7.1, p<0.03]. Unexpectedly, 89% underestimated WASO by a mean difference of 48.7 (+/-49) minutes [F(1, 14)=15.6, p<0.01]. Drinking during the first 6-week study period was predicted by both subjective estimates of WASO and their accuracy, whereas drinking during the second 6-week period was predicted by both subjective estimations of sleep and rapid eye movement sleep latency.
CONCLUSION: Greater subjective accuracy of wakefulness at night provided by the patient predicted drinking during the study. Unlike nonalcoholic insomniacs, this alcoholic sample significantly underestimated WASO compared with PSG values. The predictive ability of sleep parameters depended on the selected measure of drinking outcomes and when outcomes were measured. Subjective sleep measures were better predictors of future drinking than corresponding PSG measures.

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Year:  2006        PMID: 17117964      PMCID: PMC2935463          DOI: 10.1111/j.1530-0277.2006.00245.x

Source DB:  PubMed          Journal:  Alcohol Clin Exp Res        ISSN: 0145-6008            Impact factor:   3.455


  37 in total

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Review 10.  Alcohol's effects on sleep in alcoholics.

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  33 in total

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2.  Poor sleep at baseline predicts worse mood outcomes in patients with co-occurring bipolar disorder and substance dependence.

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4.  Improve sleep during midlife: address mental health problems early.

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5.  Effect of suvorexant on event-related oscillations and EEG sleep in rats exposed to chronic intermittent ethanol vapor and protracted withdrawal.

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Review 6.  Alcohol Dependence and Its Relationship With Insomnia and Other Sleep Disorders.

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7.  Effect of Gabapentin on Sleep and Event-Related Oscillations (EROs) in Rats Exposed to Chronic Intermittent Ethanol Vapor and Protracted Withdrawal.

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9.  Trazodone for sleep disturbance after alcohol detoxification: a double-blind, placebo-controlled trial.

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10.  A randomized double-blind pilot trial of gabapentin versus placebo to treat alcohol dependence and comorbid insomnia.

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