Sleep disturbance in individuals with alcohol dependence: findings from an exploratory mixed methods study

Authors

• AT Brooks
• M Krumlauf
• ML Schwandt
• VA Ramchandani
• GR Wallen

Abstract

Sleep disturbances are common among individuals who are alcohol-dependent and often associated with relapse. A mixed-methods approach was used to assess experiences with sleep throughout the process of alcohol rehabilitation and to explore associations between sleep-related beliefs, behavior, and sleep quality. Data were collected from a cohort of clinical research participants enrolled on an inpatient alcohol treatment protocol (n=33). Sleep was assessed approximately 1 week prior to discharge from the inpatient facility and again 4-6 weeks post-discharge (Pittsburgh Sleep Quality Index-PSQI, Epworth Sleepiness Scale-ESS, Dysfunctional Beliefs and Attitudes about Sleep-DBAS, Self-Efficacy for Sleep–SE-S, and Sleep-Related Behaviors Questionnaire-SRBQ). In addition to quantitative measures, qualitative semi-structured interviews were conducted with participants at both time points. The sample was 67% male, 45% Black/African-American, and ranged in age from 25 to 59. Average PSQI scores on day 2 of inpatient treatment, within one week of discharge from the inpatient facility, and 4 to 6 weeks post-discharge indicated disturbed sleep at all time points. Multiple linear regression modeling revealed that those whose SE-S scores increased were more likely to experience a decrease on PSQI scores pre- to post-discharge, indicating fewer sleep disturbances (β = -0.48, p < 0.05). Thematic analysis of participants’ interview transcripts yielded overarching themes of the effects of poor sleep, sleep-related beliefs, sleep environments, and sleep-related behaviors. This study demonstrates a prevalence of sleep disturbances in individuals undergoing alcohol treatment even after discharge from an inpatient treatment facility and highlights the need for behavioral sleep intervention efforts to improve outcomes.

Scientific Focus Area: Social and Behavioral Sciences

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