The course of sleep disturbances in early alcohol recovery: an observational cohort study
Abstract
INTRODUCTION: Understanding the course and determinants of sleep disturbances in alcoholic patients may help identify patients at high risk of persistent sleep problems, relapse and guide treatment interventions. METHODS: We prospectively administered the Pittsburgh Sleep Quality Index (PSQI) to all patients (N = 196) admitted to a 1-month residential treatment program. Our analysis excluded patients with active drug abuse/dependence. Demographic data, psychiatric diagnoses, Patient Health Questionnaire-9 (PHQ-9), Alcohol Use Disorders Identification Test (AUDIT) and Inventory of Drug Taking Situations (IDTS) scores were obtained. Univariate and logistic regression analyses were performed using sex, age, hazardous alcohol use, PHQ-9 scores, hypnotic use, and use of alcohol as a hypnotic as correlates to admission PSQI scores and improvement in PSQI scores. RESULTS: A total of 119 alcoholic patients met inclusion criteria (mean age 50.6 ± 13.2 years). The rates of sleep disturbances at admission and discharge were 69.3% and 49.1%, respectively. Self report of using alcohol to fall asleep and use of hypnotics were associated with elevated PSQI scores. Total PSQI scores improved over 4 weeks (p < .001). Change in PSQI scores was not effected by gender, use of hypnotics, hazardous alcohol use, use of alcohol as a hypnotic or co-morbid psychiatric diagnosis. Older age predicted improvement in PSQI scores in patients with sleep disturbances (p = .004). CONCLUSION: While a large proportion of alcoholics had sleep disturbances upon admission and at discharge from a residential treatment program, only older age was associated with improvements in sleep disturbances during early alcohol recovery.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Insomnia symptoms are common among individuals with AUD, with rates as high as 74% among those actively drinking, 69% during early recovery, and 50% after four weeks of sobriety.
“Insomnia symptoms are common among individuals with alcohol use disorder (AUD), with rates as high as 74% among those who are actively drinking, 69% during early recovery, and 50% after four weeks of sobriety (Brower et al., 2001; Chaudhary et al., 2015; Kolla et al., 2014).”
From Insomnia treatment in the context of alcohol use disorder: A systematic review and meta-analysis (2017) · cites this paper as Kolla et al., 2014
Cites
The PHQ-9: Validity of a brief depression severity measure
Kroenke, K., Spitzer, R. L., & Williams, J. B. W. (2001) · Journal of General Internal Medicine · doi:10.1046/j.1525-1497.2001.016009606.x · Cited by 44,910 · see citing works
The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research
Buysse, D. J., Reynolds, C. F., Monk, T. H., Berman, S. R., & Kupfer, D. J. (1989) · Psychiatry Research · doi:10.1016/0165-1781(89)90047-4 · Cited by 35,234 · see citing works
SAUNDERS, J. B., AASLAND, O. G., BABOR, T. F., DE LA FUENTE, J. R., & GRANT, M. (1993) · Addiction · doi:10.1111/j.1360-0443.1993.tb02093.x · Cited by 13,482 · see citing works
Bush, K. (1998) · Archives of Internal Medicine · doi:10.1001/archinte.158.16.1789 · Cited by 6,196 · see citing works
Insomnia and health-related quality of life
Kyle, S. D., Morgan, K., & Espie, C. A. (2010) · Sleep Medicine Reviews · doi:10.1016/j.smrv.2009.07.004 · Cited by 520 · see citing works
Insomnia, self-medication, and relapse to alcoholism
Brower, K. J., Aldrich, M. S., Robinson, E. A. R., Zucker, R. A., & Greden, J. F. (2001) · American Journal of Psychiatry · doi:10.1176/appi.ajp.158.3.399 · Cited by 423 · see citing works
Changes in depression among abstinent alcoholics
Brown, S. A., & Schuckit, M. A. (1988) · Journal of Studies on Alcohol · doi:10.15288/jsa.1988.49.412 · Cited by 412 · see citing works
Insomnia, alcoholism and relapse
Brower, K. J. (2003) · Sleep Medicine Reviews · doi:10.1016/s1087-0792(03)90005-0 · Cited by 354 · see citing works
The Sleep of Abstinent Pure Primary Alcoholic Patients
Drummond, S. P. A., Gillin, J. C., Smith, T. L., & DeModena, A. (1998) · Alcoholism Clinical and Experimental Research · doi:10.1111/j.1530-0277.1998.tb03983.x · Cited by 251 · see citing works
Polysomnographic and subjective sleep predictors of alcoholic relapse
Brower, K. J., Aldrich, M. S., & Hall, J. M. (1998) · Alcoholism Clinical and Experimental Research · doi:10.1111/j.1530-0277.1998.tb03995.x · Cited by 223 · see citing works
Impaired Sleep in Alcohol Misusers and Dependent Alcoholics and the Impact Upon Outcome
Foster, J., & Peters, T. J. (1999) · Alcoholism Clinical and Experimental Research · doi:10.1111/j.1530-0277.1999.tb04223.x · Cited by 153 · see citing works
Turner, N. E., Annis, H. M., & Sklar, S. M. (1997) · Behaviour Research and Therapy · doi:10.1016/s0005-7967(96)00119-2 · Cited by 110 · see citing works
Sequential studies of sleep disturbance and quality of life in abstaining alcoholics
Cohn, T., Foster, J., & Peters, T. J. (2003) · Addiction Biology · doi:10.1080/13556210310001646439 · Cited by 101 · see citing works
Brower, K. J., & Perron, B. E. (2010) · American Journal on Addictions · doi:10.1111/j.1521-0391.2010.00035.x · Cited by 89 · see citing works
Conroy, D. A., Arnedt, J. T., Brower, K. J., Strobbe, S., Consens, F. B., Hoffmann, R. F., & Armitage, R. (2006) · Alcoholism Clinical and Experimental Research · doi:10.1111/j.1530-0277.2006.00245.x · Cited by 88 · see citing works
PERSISTENT INSOMNIA, ABSTINENCE, AND MODERATE DRINKING IN ALCOHOL-DEPENDENT INDIVIDUALS
Brower, K., Krentzman, A., & Robinson, E. (2011) · American Journal on Addictions · doi:10.1111/j.1521-0391.2011.00152.x · Cited by 87 · see citing works
Currie, S. R., Clark, S. D., Rimac, S., & Malhotra, S. (2003) · Alcoholism Clinical and Experimental Research · doi:10.1097/01.alc.0000081622.03973.57 · Cited by 85 · see citing works
An open trial of cognitive-behavioral treatment for insomnia comorbid with alcohol dependence
Arnedt, J. T., Conroy, D., Rutt, J., Aloia, M. S., Brower, K. J., & Armitage, R. (2007) · Sleep Medicine · doi:10.1016/j.sleep.2006.06.007 · Cited by 84 · see citing works
Clinical Correlates of Reported Sleep Disturbance in Alcoholics
Baekeland, F., Lundwall, L. K., Shanahan, T. J., & Kissin, B. (1974) · Quarterly Journal of Studies on Alcohol · doi:10.15288/qjsa.1974.35.1230 · Cited by 46 · see citing works
Pharmacological Treatment of Insomnia in Alcohol Recovery: A Systematic Review
Kolla, B. P., Mansukhani, M. P., & Schneekloth, T. D. (2011) · Alcohol and Alcoholism · doi:10.1093/alcalc/agr073 · Cited by 44 · see citing works
Self-citationComplaints of insomnia in hospitalized alcoholics
Escobar-Córdoba, F., Ávila-Cadavid, J. D., & Cote-Menéndez, M. (2009) · Brazilian Journal of Psychiatry · doi:10.1590/s1516-44462009000300013 · Cited by 20 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Alcohol use disorder and sleep disturbances: a feed-forward allostatic framework
Koob, G. F., & Colrain, I. M. (2019) · Neuropsychopharmacology · doi:10.1038/s41386-019-0446-0 · Cited by 280 · see citing works
Alcohol Dependence and Its Relationship With Insomnia and Other Sleep Disorders
Chakravorty, S., Chaudhary, N. S., & Brower, K. J. (2016) · Alcoholism Clinical and Experimental Research · doi:10.1111/acer.13217 · Cited by 244 · see citing works
Assessment and treatment of insomnia in adult patients with alcohol use disorders
Brower, K. J. (2015) · Alcohol · doi:10.1016/j.alcohol.2014.12.003 · Cited by 134 · see citing works
Insomnia treatment in the context of alcohol use disorder: A systematic review and meta-analysis
Miller, M. B., Donahue, M. L., Carey, K. B., & Scott-Sheldon, L. A. J. (2017) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2017.09.029 · Cited by 78 · see citing works
Alterations in circadian rhythms following alcohol use: A systematic review
Meyrel, M., Rolland, B., & Geoffroy, P. A. (2019) · Progress in Neuro-Psychopharmacology and Biological Psychiatry · doi:10.1016/j.pnpbp.2019.109831 · Cited by 64 · see citing works
Management of insomnia in alcohol use disorder
Geoffroy, P. A., Lejoyeux, M., & Rolland, B. (2020) · Expert Opinion on Pharmacotherapy · doi:10.1080/14656566.2019.1705279 · Cited by 50 · see citing works
Kolla, B. P., Schneekloth, T. D., Mansukhani, M. P., Biernacka, J. M., Hall‐Flavin, D. K., Karpyak, V. M., Geske, J. R., & Frye, M. A. (2015) · American Journal on Addictions · doi:10.1111/ajad.12199 · Cited by 39 · see citing works
Self-citationMagnée, E. H. B., Oene, G. H. D. W.-V., Wijdeveld, T. G. M., Coenen, A., & Jong, C. D. D. (2015) · American Journal on Addictions · doi:10.1111/ajad.12243 · Cited by 36 · see citing works
Kolla, B. P., Mansukhani, M. P., Biernacka, J. M., Chakravorty, S., & Karpyak, V. M. (2019) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2019.107655 · Cited by 32 · see citing works
Self-citationSánchez-Alavez, M., Benedict, J., Wills, D. N., & Ehlers, C. L. (2019) · SLEEP · doi:10.1093/sleep/zsz020 · Cited by 27 · see citing works
Lanièpce, A., Lahbairi, N., Cabé, N., Pitel, A., & Rauchs, G. (2021) · Sleep Medicine Reviews · doi:10.1016/j.smrv.2021.101435 · Cited by 26 · see citing works
Gendy, M. N. S., Lagzdins, D., Schaman, J., & Foll, B. L. (2020) · Scientific Reports · doi:10.1038/s41598-020-65166-y · Cited by 22 · see citing works
Kitzinger, R. H., Gardner, J., Moran, M., Celkos, C., Fasano, N., Linares, E., Muthee, J., & Royzner, G. (2023) · Substance Abuse Research and Treatment · doi:10.1177/11782218231153843 · Cited by 22 · see citing works
Freet, C. S., Evans, B., Brick, T. R., Deneke, E., Wasserman, E. J., Ballard, S. M., Stankoski, D. M., Kong, L., Raja-Khan, N. T., Nyland, J. E., et al. (2024) · Addiction Science & Clinical Practice · doi:10.1186/s13722-024-00481-7 · Cited by 21 · see citing works
Roehrs, T., Auciello, J., Tseng, J., & Whiteside, G. T. (2020) · Neuropsychopharmacology Reports · doi:10.1002/npr2.12117 · Cited by 20 · see citing works
Guo, Y., Hu, H., Liu, Y., Leng, Y., Gao, X., Cui, Q., Chen, J., Geng, B., & Zhou, Y. (2018) · PLoS ONE · doi:10.1371/journal.pone.0207392 · Cited by 20 · see citing works
Filippis, S. D., Martinotti, G., Nicoletti, F., Mastrostefano, A., Trovini, G., Pugliese, A., & Nicola, M. D. (2024) · Current Neuropharmacology · doi:10.2174/1570159x22666240827165327 · Cited by 20 · see citing works
Severity of Substance Use Disorder: Utility as an Outcome in Clinical Settings
Dacosta‐Sánchez, D., Fernández‐Calderón, F., González‐Ponce, B. M., Díaz, C., & Lozano, O. M. (2019) · Alcoholism Clinical and Experimental Research · doi:10.1111/acer.14020 · Cited by 16 · see citing works
Taylor, D. J., Gehrman, P., Dautovich, N. D., Lichstein, K. L., & McCrae, C. S. (2014) · doi:10.1007/978-1-907673-73-3 · Cited by 15 · see citing works
Sánchez-Alavez, M., Wills, D. N., Amodeo, L. R., & Ehlers, C. L. (2017) · Alcoholism Clinical and Experimental Research · doi:10.1111/acer.13588 · Cited by 10 · see citing works
Piekarski, D. J., Sullivan, E. V., Pfefferbaum, A., & Zahr, N. M. (2022) · Alcohol · doi:10.1016/j.alcohol.2022.07.001 · Cited by 10 · see citing works
Neu, P., Sofin, Y., & Danker‐Hopfe, H. (2018) · Journal of Addiction · doi:10.1155/2018/9492453 · Cited by 10 · see citing works
Management of Insomnia in Patients with Alcohol Use Disorder
Schubert, J. R., & Arnedt, J. T. (2017) · Current Sleep Medicine Reports · doi:10.1007/s40675-017-0066-3 · Cited by 9 · see citing works
Arnedt, J. T., Cardoni, M. E., Conroy, D. A., Graham, M., Amin, S., Bohnert, K. M., Krystal, A. D., & Ilgen, M. A. (2022) · Trials · doi:10.1186/s13063-021-05898-y · Cited by 7 · see citing works
Li, X., Shi, Z., Byanyima, J. I., MORGAN, P. T., van der Veen, J.-W., Zhang, R., Deneke, E., Wang, G., Volkow, N. D., & Wiers, C. E. (2022) · Drug and Alcohol Dependence Reports · doi:10.1016/j.dadr.2022.100092 · Cited by 5 · see citing works
Kolla, B. P., Winham, S. J., Ho, A. M., Mansukhani, M. P., Loukianova, L. L., Pazdernik, V., & Karpyak, V. M. (2023) · Alcohol and Alcoholism · doi:10.1093/alcalc/agad001 · Cited by 5 · see citing works
Self-citationMiller, M. B., Freeman, L. K., Curtis, A. F., Boissoneault, J., & McCrae, C. S. (2020) · Elsevier eBooks · doi:10.1016/b978-0-12-816658-1.00027-2 · Cited by 5 · see citing works
Miller, M. B., Metrik, J., McGeary, J. E., Borsari, B. E., McCrae, C. S., Maddoux, J. A., Arnedt, J. T., Merrill, J. E., & Carey, K. B. (2021) · BMJ Open · doi:10.1136/bmjopen-2020-045667 · Cited by 5 · see citing works
Kolla, B. P., Biernacka, J. M., Mansukhani, M. P., Colby, C. L., & Coombes, B. J. (2021) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2021.109128 · Cited by 5 · see citing works
Self-citationSubstance Abuse and Sleep Quality in University Students
Mousavi, M. Z., Tamimi, A., Farsam, M., & Kousha, M. (2024) · Addiction and Health · doi:10.34172/ahj.2024.1445 · Cited by 4 · see citing works
Ko, S., Park, Y., Kang, M., & Hong, H.-S. (2017) · Journal of Korean Biological Nursing Science · doi:10.7586/jkbns.2017.19.1.48 · Cited by 4 · see citing works
Cannabis use as a moderator of cognitive behavioral therapy for insomnia
Miller, M. B., Carpenter, R. W., Freeman, L. K., Curtis, A. F., Yurasek, A. M., & McCrae, C. S. (2021) · Journal of Clinical Sleep Medicine · doi:10.5664/jcsm.9796 · Cited by 3 · see citing works
Addiction et troubles du sommeil : craving, rythmes circadiens. Une mise au point
Auriacombe, M., Debrabant, R., Kervran, C., Serre, F., Taillard, J., Philip, P., Denis, C., & Fatseas, M. (2016) · Médecine du Sommeil · doi:10.1016/j.msom.2016.04.004 · Cited by 2 · see citing works
Neale, J., Strekalova, K. D., Meadows, R. P., & Nettleton, S. (2019) · Journal of Substance Use · doi:10.1080/14659891.2019.1595196 · Cited by 2 · see citing works
Insomnia Due to Drug or Substance Abuse and Dependence
Hairston, I. S., Akbar, N. Z., & Conroy, D. A. (2013) · Elsevier eBooks · doi:10.1016/b978-0-12-378610-4.00183-2 · Cited by 2 · see citing works
de Magalhães, L. F., Neto, R. M., Ibieta, S. M. S., Duran, T. C. A. L., Jorge, A. C., & Neto, A. R. D. S. (2022) · Research Society and Development · doi:10.33448/rsd-v11i12.32965 · Cited by 1 · see citing works
A Sleep Health Education Intervention Improves Sleep Knowledge in Social Work Students
Spadola, C., Groton, D. B., Raval, M., Hilditch, C. J., Littlewood, K., Baiden, P., Bertisch, S. M., & Zhou, E. S. (2024) · Social Sciences · doi:10.3390/socsci13070364 · Cited by 1 · see citing works
Górowska, M. P., Tokarska, K., Li, Y., & Chen, X. (2025) · Current Psychology · doi:10.1007/s12144-025-08120-3 · Cited by 1 · see citing works
Sleep Disturbances Across the Addiction Stages: A Review of Alcohol, Cannabis and their Co-Use
Padula, C. B., Grayson, A., Izabel, S. S., Tenekedjieva, L., Zhang, E. Q., & Goldstein‐Piekarski, A. N. (2025) · Current Addiction Reports · doi:10.1007/s40429-025-00681-4 · Cited by 1 · see citing works
Managing Insomnia in Special Populations
Taylor, D. J., Gehrman, P., Dautovich, N. D., Lichstein, K. L., & McCrae, C. S. (2014) · doi:10.1007/978-1-907673-73-3_5 · Cited by 1 · see citing works
Gendy, M. N. S. (2019) · TSpace (University of Toronto) · Cited by 1 · see citing works
Impact of psychological disorders
Carney, C. E., Moss, T. G., & Carney, A. E. (2021) · Elsevier eBooks · doi:10.1016/b978-0-12-822963-7.00074-8
Substance-related disorders and sleep
Reffi, A. N., Kolla, B. P., Graham, M., Cardoni, M. E., Amin, S., Conroy, D. A., & Arnedt, J. T. (2021) · Elsevier eBooks · doi:10.1016/b978-0-12-822963-7.00086-4
Self-citationInsomnia due to drug or substance abuse and dependence
Hadler, N. L., Hairston, I. S., & Conroy, D. A. (2021) · Elsevier eBooks · doi:10.1016/b978-0-12-822963-7.00014-1
Tan, J., Zeng, J., Jiao, B., Li, J., Zhong, D., Yang, N., Qian, G., Wen, G., Zhou, P., & Pei, W. (2025) · Natural Product Communications · doi:10.1177/1934578x251344991
Sleep in Patients With Substance Use Disorders
Cardoni, M. E., Kolla, B. P., Graham, M., Bronsteyn, Y., & Arnedt, J. T. (2025) · Oxford University Press eBooks · doi:10.1093/oxfordhb/9780197602751.013.31
Self-citationWolińska, W., Giezek, M., Szylińska, A., Scech, M. W., & Knyszyńska, A. (2026) · Journal of Clinical Medicine · doi:10.3390/jcm15041400
- Authors
- Kolla, B. P., Schneekloth, T., Biernacka, J., Mansukhani, M., Geske, J., Karpyak, V., Hall‐Flavin, D., Louikianova, L., & Frye, M. A.
- Affiliations
- Mayo Clinic (US)
- Corresponding author
- Kolla, Bhanu Prakash
- ORCID
- Venue
- The American Journal on Addictions
- Publisher
- Wiley
- Published
- 2013-12-27
- Volume
- 23
- Issue
- 1
- Pages
- 21-26
- ISSN
- 1055-0496 (ISSN-L)
- 1521-0391
- OpenAlex
- W2099747894
- Cited by
- 47
- References
- 21
- Citations by year
- 2026: 1 · 2025: 4 · 2024: 4 · 2023: 2 · 2022: 4 · 2021: 7 · 2020: 4 · 2019: 7 · 2018: 2 · 2017: 4 · 2016: 2 · 2015: 3 · 2014: 2 · 2013: 1
- FWCI
- 3.61
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- American Journal on Addictions (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Health Sciences › Medicine › Physiology › Obstructive Sleep Apnea Research
- Keywords
- sleep disorders, alcoholism, alcohol recovery, residential treatment, Pittsburgh Sleep Quality Index, hypnotic use, age as predictor, relapse risk, psychiatric comorbidity
- MeSH terms
- Adult, Aged, Aged, 80 and over, Alcoholism, Female, Humans, Sleep Initiation and Maintenance Disorders, Male, Middle Aged, Prognosis, Psychiatric Status Rating Scales, Residential Treatment, Cohort Studies, Logistic Models, Treatment Outcome, Diagnosis, Dual (Psychiatry), Young Adult
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
