Bhanu Prakash Kolla1, Meghna P Mansukhani2, Joanna Biernacka3, Subhajit Chakravorty4, Victor M Karpyak3. 1. Department of Psychiatry and Psychology, Mayo Clinic, 2nd ST SW, Rochester, MN 55905, USA; Center for Sleep Medicine, Mayo Clinic, 2nd ST SW, Rochester, MN 55905, USA. Electronic address: kolla.bhanuprakash@mayo.edu. 2. Department of Psychiatry and Psychology, Mayo Clinic, 2nd ST SW, Rochester, MN 55905, USA. 3. Department of Biostatistics, Mayo Clinic, 2nd ST SW, Rochester, MN 55905, USA. 4. Department of Psychiatry, Perelman School of Medicine, 3400 Civic Center Blvd, Philadelphia, PA 19104, USA.
Abstract
AIMS: We aimed to assess the prevalence of sleep disturbance in early alcohol recovery and its association with psychiatric comorbidity, cravings, propensity and severity of alcohol consumption. DESIGN: The sample consisted of 18-80 year old patients (n = 303) receiving treatment for alcohol dependence. Sleep disturbance was measured using the Pittsburgh Sleep Quality Index (PSQI). Additional measures included PHQ-9, GAD-7 and Penn alcohol cravings scale (PACS), Inventory of Drug Taking Situations (IDTS) and alcohol consumption was measured utilizing the Time Line Follow Back (TLFB).Bivariate analyses evaluated the association between PSQI total score and other clinical characteristics. A multivariable model was computed for sleep disturbance with predictors entered into the model using automated stepwise selection. FINDINGS: The sample was majority male (66%), White (93%) with a mean age of 42.2 ± 11.6 years. Baseline PSQI score was 10.2 ± 4.13 and most subjects (88%) reported sleep disturbance at baseline. Baseline sleep disturbance was associated with depressive symptoms (p < .0001), anxiety symptoms (p < .0001), craving (p < .0001), propensity to drink when experiencing unpleasant emotions (p < .0001), physical discomfort (p < .0001), loss of personal control (p = 0.03), conflict (p = 0.002), number of drinks consumed (p = 0.004), drinking days (p = 0.004) and hazardous drinking days (p = 0.03) in bivariate analyses. However, in the multivariable model, only PHQ-9 total score and IDTS physical discomfort subscale were associated with sleep disturbance. CONCLUSION: Sleep disruption is common in early alcohol recovery. Future studies should examine the prognostic and clinical implications of its association with current depressive symptoms and a propensity to drink while experiencing physical discomfort.
AIMS: We aimed to assess the prevalence of sleep disturbance in early alcohol recovery and its association with psychiatric comorbidity, cravings, propensity and severity of alcohol consumption. DESIGN: The sample consisted of 18-80 year old patients (n = 303) receiving treatment for alcohol dependence. Sleep disturbance was measured using the Pittsburgh Sleep Quality Index (PSQI). Additional measures included PHQ-9, GAD-7 and Penn alcohol cravings scale (PACS), Inventory of Drug Taking Situations (IDTS) and alcohol consumption was measured utilizing the Time Line Follow Back (TLFB).Bivariate analyses evaluated the association between PSQI total score and other clinical characteristics. A multivariable model was computed for sleep disturbance with predictors entered into the model using automated stepwise selection. FINDINGS: The sample was majority male (66%), White (93%) with a mean age of 42.2 ± 11.6 years. Baseline PSQI score was 10.2 ± 4.13 and most subjects (88%) reported sleep disturbance at baseline. Baseline sleep disturbance was associated with depressive symptoms (p < .0001), anxiety symptoms (p < .0001), craving (p < .0001), propensity to drink when experiencing unpleasant emotions (p < .0001), physical discomfort (p < .0001), loss of personal control (p = 0.03), conflict (p = 0.002), number of drinks consumed (p = 0.004), drinking days (p = 0.004) and hazardous drinking days (p = 0.03) in bivariate analyses. However, in the multivariable model, only PHQ-9 total score and IDTS physical discomfort subscale were associated with sleep disturbance. CONCLUSION: Sleep disruption is common in early alcohol recovery. Future studies should examine the prognostic and clinical implications of its association with current depressive symptoms and a propensity to drink while experiencing physical discomfort.
Authors: Mary Beth Miller; Lindsey Freeman; Chan Jeong Park; Nicole A Hall; Chelsea Deroche; Pradeep K Sahota; Christina S McCrae Journal: Alcohol Clin Exp Res Date: 2021-04-05 Impact factor: 3.455