Insomnia, self-medication, and relapse to alcoholism
Open accessAbstract
OBJECTIVE: This study was an investigation of the frequencies of insomnia and its self-medication with alcohol in a group of alcoholic patients, as well as the relationship of these variables to alcoholic relapse. METHOD: The subjects were 172 men and women receiving treatment for alcohol dependence. They completed a sleep questionnaire, measures of alcohol problem severity and depression severity, and polysomnography after at least 2 weeks of abstinence. RESULTS: On the basis of eight items from the Sleep Disorders Questionnaire, 61% of the subjects were classified as having symptomatic insomnia during the 6 months before treatment entry. Compared to patients without insomnia, patients with insomnia were more likely to report frequent alcohol use for sleep (55% versus 28%), had significantly worse polysomnographic measures of sleep continuity, and had more severe alcohol dependence and depression. Among 74 alcoholics who were followed a mean of 5 months after treatment, 60% with baseline insomnia versus 30% without baseline insomnia relapsed to any use of alcohol, a significant difference. Insomnia remained a robust predictor of relapse after application of logistic regression analysis to control for other variables. A history of self-medicating insomnia with alcohol did not significantly predict subsequent relapse. CONCLUSIONS: The majority of alcoholic patients entering treatment reported insomnia symptoms. Given the potential link between insomnia and relapse, routine questions about sleep in clinical and research settings are warranted.
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In the context of alcohol treatment, insomnia symptoms precede and predict relapse to alcohol use.
“Moreover, in the context of alcohol treatment, insomnia symptoms have been shown to precede and predict relapse to alcohol use (Brower et al., 2001; Malcolm et al., 2007; Smith et al., 2014).”
From Insomnia treatment in the context of alcohol use disorder: A systematic review and meta-analysis (2017) · cites this paper as Brower et al., 2001
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 Brower et al., 2001
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- Authors
- Brower, K. J., Aldrich, M. S., Robinson, E. A. R., Zucker, R. A., & Greden, J. F.
- Affiliations
- University of Michigan (US)
- Venue
- American Journal of Psychiatry
- Published
- 2001-03-01
- Volume
- 158
- Issue
- 3
- Pages
- 399-404
- ISSN
- 0002-953X (ISSN-L)
- 1535-7228
- PMC
- PMC3008542
- OpenAlex
- W2140411869
- Cited by
- 423
- References
- 39
- Citations by year
- 2026: 6 · 2025: 20 · 2024: 15 · 2023: 12 · 2022: 24 · 2021: 21 · 2020: 32 · 2019: 23 · 2018: 19 · 2017: 13 · 2016: 21 · 2015: 25 · 2014: 35 · 2013: 22 · 2012: 17
- FWCI
- 16.39
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- American Journal of Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute on Alcohol Abuse and Alcoholism (AA 07378, K24AA000304, AA 07477, P50AA007378, AA-00304, T32AA007477)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Health Sciences › Health Professions › General Health Professions › Homelessness and Social Issues
- Keywords
- insomnia, self-medication, alcohol relapse, alcoholism, sleep continuity, depression, polysomnography, predictors of relapse, sleep disorders
- MeSH terms
- Adult, Alcohol Drinking, Ethanol, Alcoholism, Chronic Disease, Depressive Disorder, Follow-Up Studies, Humans, Sleep Initiation and Maintenance Disorders, Male, Middle Aged, Psychiatric Status Rating Scales, Surveys and Questionnaires, Recurrence, Regression Analysis, Self Medication, Severity of Illness Index, Comorbidity, Treatment Outcome, Polysomnography
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