"This study provides important, further validation of the significance of sleep problems in recovering alcoholics," said Currie. "Insomnia is a highly variable disorder; most insomniacs experience both good and bad nights of sleep in a typical week, so it is important to obtain several nights of data to get an accurate picture of how severe the problem is. Just as physicians like to obtain several readings of blood pressure before diagnosing hypertension, it is likewise important to obtain several nights of sleep information to diagnose a sleep disorder. The monitor that we used, in conjunction with participants' detailed sleep diaries, confirmed that alcoholics did indeed have persistent sleep disruptions that could not be attributed to a single bad night of sleep in a lab."
The study also found that, in general, problems with sleep onset were worse than with sleep maintenance.
"Most insomniacs have a combination of problems getting to sleep and problems staying asleep," said Currie. "Our results indicate that most recovering alcoholics have both types of insomnia but the onset problem is generally worse."
More than half of the participants reported sleep problems that predated the onset of alcohol dependence.
"The rate of chronic insomnia in the general adult population is about 10 to 15 percent," said Currie. "In our study, more than 50 percent of the alcoholics reported having sleep problems for many years before their drinking reached dependence levels. Although we cannot infer any causal connection between insomnia and alcoholism from this data, it is hard to ignore such a high rate of pre-existing sleep problems in the sample."
In addition, poor sleep hygiene was evident among the recovering alcoholics. "Sleep hygiene refers to behaviors that constitute good sleep habits, such as keeping a regular rising time, avoiding napping, and refraining from stimulants like caffeine in the evening," said Currie.
"Many people believe that having a drink will help their sleep," noted Hodgins. "In fact, many physicians will informally suggest the use of alcohol as a sleep aid. However, these findings warn against developing the habit of having, for example, a glass of wine to help go to sleep. More importantly, these findings lead to the idea of targeted interventions with alcoholics. Despite the very comprehensive and broad-based nature of most treatment programs, very, very few of them tackle sleep as an issue. But sleep is obviously a problem for some people and a relevant area of intervention. Trying to refrain from drinking can take a lot of vigilance, self-control and self-worth; it would be even more difficult for someone if they were exhausted."
Currie is currently wrapping up a study that involves a non-pharmaceutical treatment (cognitive-behavioural therapy) for sleep problems in recovering alcoholics. "It may be that sleep can be improved in recovering alcoholics through using an approach that emphasizes good sleep habits, relaxation and stress management," he said.
Part One: Sleep Problems for Alcoholics
Source: Alcoholism: Clinical & Experimental Research News Release