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Geoffroy PA, Lejoyeux M, Rolland B. Management of insomnia in alcohol use disorder. Expert Opin Pharmacother 2020; 21:297-306. [DOI: 10.1080/14656566.2019.1705279] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Affiliation(s)
- Pierre A. Geoffroy
- Département de psychiatrie et d’addictologie, AP-HP, Hopital Bichat - Claude Bernard, Paris, France
- NeuroDiderot, Inserm, Université de Paris, Paris, France
| | - Michel Lejoyeux
- Département de psychiatrie et d’addictologie, AP-HP, Hopital Bichat - Claude Bernard, Paris, France
- Department of Epidemiology, Paris Hospital Group - Psychiatry & Neurosciences, Paris, France
| | - Benjamin Rolland
- Pôle MOPHA, CH Le Vinatier, Service Universitaire d’Addictologie de Lyon (SUAL), Bron, France
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102
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Koob GF, Colrain IM. Alcohol use disorder and sleep disturbances: a feed-forward allostatic framework. Neuropsychopharmacology 2020; 45:141-165. [PMID: 31234199 PMCID: PMC6879503 DOI: 10.1038/s41386-019-0446-0] [Citation(s) in RCA: 122] [Impact Index Per Article: 30.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Revised: 06/09/2019] [Accepted: 06/13/2019] [Indexed: 11/09/2022]
Abstract
The development of alcohol use disorder (AUD) involves binge or heavy drinking to high levels of intoxication that leads to compulsive intake, the loss of control in limiting intake, and a negative emotional state when alcohol is removed. This cascade of events occurs over an extended period within a three-stage cycle: binge/intoxication, withdrawal/negative affect, and preoccupation/anticipation. These three heuristic stages map onto the dysregulation of functional domains of incentive salience/habits, negative emotional states, and executive function, mediated by the basal ganglia, extended amygdala, and frontal cortex, respectively. Sleep disturbances, alterations of sleep architecture, and the development of insomnia are ubiquitous in AUD and also map onto the three stages of the addiction cycle. During the binge/intoxication stage, alcohol intoxication leads to a faster sleep onset, but sleep quality is poor relative to nights when no alcohol is consumed. The reduction of sleep onset latency and increase in wakefulness later in the night may be related to the acute effects of alcohol on GABAergic systems that are associated with sleep regulation and the effects on brain incentive salience systems, such as dopamine. During the withdrawal/negative affect stage, there is a decrease in slow-wave sleep and some limited recovery in REM sleep when individuals with AUD stop drinking. Limited recovery of sleep disturbances is seen in AUD within the first 30 days of abstinence. The effects of withdrawal on sleep may be related to the loss of alcohol as a positive allosteric modulator of GABAA receptors, a decrease in dopamine function, and the overactivation of stress neuromodulators, including hypocretin/orexin, norepinephrine, corticotropin-releasing factor, and cytokines. During the preoccupation/anticipation stage, individuals with AUD who are abstinent long-term present persistent sleep disturbances, including a longer latency to fall asleep, more time awake during the night, a decrease in slow-wave sleep, decreases in delta electroencephalogram power and evoked delta activity, and an increase in REM sleep. Glutamatergic system dysregulation that is observed in AUD is a likely substrate for some of these persistent sleep disturbances. Sleep pathology contributes to AUD pathology, and vice versa, possibly as a feed-forward drive to an unrecognized allostatic load that drives the addiction process.
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Affiliation(s)
- George F Koob
- National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, 6700B Rockledge Drive, Room 1209, MSC 6902, Bethesda, MD, 20892-6902, USA.
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, MD, 20892-6902, USA.
| | - Ian M Colrain
- SRI Biosciences, SRI International, Menlo Park, CA, USA
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, Australia
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103
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Abstract
Sleep disturbance is common among individuals with alcohol use disorder (AUD). Insomnia not only is a pathway toward alcohol consumption but also is related to increased risk of relapse, psychosocial impairment, decreased quality of life, and suicidal ideation in individuals with AUD. Few studies examining sleep disturbance and alcohol use have explored how this relationship differs between men and women. Historically, studies of AUD have included few, if any, women in their samples. However, women are increasingly consuming alcohol at an earlier age and at higher rates, and the effect of alcohol on women's mental and physical health is expected to rise. This narrative review consolidates findings from studies that have reported the effects of acute and chronic alcohol use on sleep among women. Additional research is needed to investigate sex differences in this area. Such research should consider the modifying effects of age, lifetime alcohol use, and psychiatric co-occurrence, as well as the effectiveness of combined interventions for AUD and sleep disturbance.
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Affiliation(s)
- Sarah M Inkelis
- Joint Doctoral Program in Clinical Psychology, San Diego State University and University of California San Diego, San Diego, California
| | - Brant P Hasler
- Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Fiona C Baker
- Center for Health Sciences, SRI International, Menlo Park, California; School of Physiology, University of the Witwatersrand, Johannesburg, South Africa
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104
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Kolla BP, Mansukhani MP, Biernacka J, Chakravorty S, Karpyak VM. Sleep disturbances in early alcohol recovery: Prevalence and associations with clinical characteristics and severity of alcohol consumption. Drug Alcohol Depend 2020; 206:107655. [PMID: 31744670 DOI: 10.1016/j.drugalcdep.2019.107655] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Revised: 08/01/2019] [Accepted: 08/05/2019] [Indexed: 11/24/2022]
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.
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Affiliation(s)
- Bhanu Prakash Kolla
- 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.
| | - Meghna P Mansukhani
- Department of Psychiatry and Psychology, Mayo Clinic, 2nd ST SW, Rochester, MN 55905, USA
| | - Joanna Biernacka
- Department of Biostatistics, Mayo Clinic, 2nd ST SW, Rochester, MN 55905, USA
| | - Subhajit Chakravorty
- Department of Psychiatry, Perelman School of Medicine, 3400 Civic Center Blvd, Philadelphia, PA 19104, USA
| | - Victor M Karpyak
- Department of Biostatistics, Mayo Clinic, 2nd ST SW, Rochester, MN 55905, USA
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105
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Brauer AA, Athey AB, Ross MJ, Grandner MA. Sleep and Health Among Collegiate Student Athletes. Chest 2019; 156:1234-1245. [DOI: 10.1016/j.chest.2019.08.1921] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Revised: 07/02/2019] [Accepted: 08/09/2019] [Indexed: 12/15/2022] Open
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106
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Sleep disturbances in HIV-HCV coinfected patients: indications for clinical management in the HCV cure era (ANRS CO13 HEPAVIH cohort). Eur J Gastroenterol Hepatol 2019; 31:1508-1517. [PMID: 31094856 DOI: 10.1097/meg.0000000000001441] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
OBJECTIVES Although common among patients coinfected with HIV and hepatitis C virus (HCV), sleep disturbances (SD) are still poorly documented in this population in the HCV cure era. This longitudinal study aimed at analysing SD in HIV-HCV coinfected patients and identifying their clinical and sociobehavioural correlates. METHODS We used 5-year annual follow-up data from 1047 participants in the French National Agency for Research on Aids and Viral Hepatitis Cohort 13 'Hépatite et VIH' (ANRS CO13 HEPAVIH) cohort of HIV-HCV coinfected patients to identify clinical (medical records) and behavioural (self-administered questionnaires) correlates of SD (mixed-effects logistic regression). SD were identified using one item documenting the occurrence of insomnia or difficulty falling asleep (ANRS 'Action Coordonnée 24' self-reported symptoms checklist), and two items documenting perceived sleep quality (Center for Epidemiologic Studies Depression and WHO Quality of Life HIV-specific brief scales). RESULTS Seven hundred and sixteen (68.4%) patients with completed self-administered questionnaires reported SD at their most recent follow-up visit. In the multivariable model, hazardous alcohol consumption (Alcohol Use Disorders Identification Test-Consumption score ≥ 4 for men, ≥ 3 for women) (adjusted odds ratio = 1.61; 95% confidence interval: 1.09-2.36), depressive symptoms (6.78; 4.36-10.55) and the number of other physical and psychological self-reported symptoms (1.10; 1.07-1.13) were associated independently with SD after adjustment for sex, age and employment status. HCV cure was not associated significantly with SD. CONCLUSION SD remain frequent in HIV-HCV coinfected patients and are associated with a series of modifiable behavioural risk factors. Independent of HCV cure, improved screening and comprehensive management of alcohol use, physical and psychological self-reported symptoms and depression are essential in this population. Closer investigation of these risk factors of SDs may both increase sleep quality and indirectly improve patients' clinical outcomes.
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107
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He S, Brooks AT, Kampman KM, Chakravorty S. The Relationship between Alcohol Craving and Insomnia Symptoms in Alcohol-Dependent Individuals. Alcohol Alcohol 2019; 54:287-294. [PMID: 31087085 DOI: 10.1093/alcalc/agz029] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2018] [Revised: 03/19/2019] [Accepted: 03/20/2019] [Indexed: 11/13/2022] Open
Abstract
AIM This preliminary investigation evaluated the link between alcohol craving and insomnia in actively drinking patients with alcohol dependence (AD). METHODS We conducted a secondary analysis of data from a clinical trial of treatment-seeking patients with AD who drank heavily (N = 61). The Penn Alcohol Craving Scale (PACS) evaluated alcohol craving, and the Short Sleep Index (SSI) assessed insomnia symptoms. We used linear regression models for baseline cross-sectional assessments. Linear mixed effects regression models evaluated craving scores longitudinally across insomnia groups (+/-), and insomnia scores longitudinally across craving groups(high/low). These longitudinal analyses were conducted separately in those treated with placebo (N = 32) and quetiapine (N = 29). RESULTS The mean (standard deviation) for PACS total score was 15.9 (8.5) and for SSI was 2.1 (2.3). Alcohol craving was associated with the insomnia symptom of difficulty falling asleep (P = 0.03; effect size = -0.7) and with the SSI total score (P = 0.04, effect size = -0.7). In the longitudinal analysis, insomnia+ subjects had consistently higher PACS total scores, relative to the insomnia- group. The PACS score demonstrated significant group × time interactions in both treatment groups. Insomnia+ individuals demonstrated a relatively steeper rate of decline in the craving with quetiapine treatment (P = 0.03). Insomnia- individuals in the placebo group demonstrated a transient reduction in craving until week 8, followed by an increase in scores(P = 0.004). The SSI score did not demonstrate any interactive effect over time across the craving groups in either treatment arm. CONCLUSION Insomnia was associated with higher alcohol craving and quetiapine differentially reduced craving in those with insomnia.
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Affiliation(s)
- Sean He
- Department of R & D, Cpl. Michael J. Crescenz VA Medical Center, PA, USA.,School of Arts and Sciences, University of Pennsylvania, Philadelphia, PA, USA.,St. Louis University School of Medicine, St. Louis, MO, USA
| | - Alyssa T Brooks
- Department of Nursing, National Institutes of Health Clinical Center, Bethesda, MD, USA
| | - Kyle M Kampman
- Department of R & D, Cpl. Michael J. Crescenz VA Medical Center, PA, USA.,Department of Psychiatry, Perelman School of Medicine, Philadelphia, PA, USA
| | - Subhajit Chakravorty
- Department of R & D, Cpl. Michael J. Crescenz VA Medical Center, PA, USA.,Department of Psychiatry, Perelman School of Medicine, Philadelphia, PA, USA
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108
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Panin F, Peana AT. Sleep and the Pharmacotherapy of Alcohol Use Disorder: Unfortunate Bedfellows. A Systematic Review With Meta-Analysis. Front Pharmacol 2019; 10:1164. [PMID: 31680952 PMCID: PMC6811753 DOI: 10.3389/fphar.2019.01164] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Accepted: 09/10/2019] [Indexed: 12/13/2022] Open
Abstract
Background: Sleep disorders are commonly associated with acute and chronic use of alcohol and with abstinence. To date, there are four approved drugs to treat alcohol use disorder (AUD): disulfiram, acamprosate, naltrexone, and nalmefene. These AUD therapies reduce the craving and risk of relapse into heavy drinking, but little is known about their effect on sleep. As recent evidences indicate a crucial role of sleep disorders in AUD, claiming that sleep problems may trigger alcohol abuse and relapses, it is fundamental to clarify the impact of those drugs on the sleep quality of AUD patients. This systematic review aims to answer the question: how does the pharmacotherapy for AUD affect sleep? Methods: We searched PubMed, Embase, CINAHL Plus, Cochrane, and Scopus using sleep- and AUD pharmacotherapy-related keywords. The articles included were appraised using the CASP checklists, and the risk of bias was assessed following the Cochrane risk-of-bias assessment tool. Finally, we pooled sleep outcomes in a meta-analysis to measure the overall effect. Results and Conclusion: We included 26 studies: only three studies focused on sleep as a main outcome, two with polysomnography (objective measurement), and one with subjective self-reported sleep, while all the other studies reported sleep problems among the adverse effects (subjective report). The only study available on disulfiram showed reduced REM sleep. Acamprosate showed no/little effect on self-reported sleep but improved sleep continuity and architecture measured by polysomnography. The two opioidergic drugs naltrexone and nalmefene had mainly detrimental effect on sleep, giving increased insomnia and/or somnolence compared with placebo, although not always significant. The meta-analysis confirmed significantly increased somnolence and insomnia in the naltrexone group, compared with the placebo. Overall, the currently available evidences show more sleep problems with the opioidergic drugs (especially naltrexone), while acamprosate seems to be well tolerated or even beneficial. Acamprosate might be a more suitable choice when patients with AUD report sleep problems. Due to the paucity of information available, and with the majority of results being subjective, more research on this topic is needed to further inform the clinical practice, ideally with more objective measurements such as polysomnography.
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Affiliation(s)
- Francesca Panin
- Faculty of Health, Education, Medicine and Social Care, Anglia Ruskin University, Cambridge, United Kingdom
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109
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Hasler BP, Pedersen SL. Sleep and circadian risk factors for alcohol problems: a brief overview and proposed mechanisms. Curr Opin Psychol 2019; 34:57-62. [PMID: 31629218 DOI: 10.1016/j.copsyc.2019.09.005] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Revised: 08/22/2019] [Accepted: 09/05/2019] [Indexed: 12/12/2022]
Abstract
Disturbances in sleep and circadian rhythms may be important, albeit underappreciated, risk factors for the initiation of alcohol use and the escalation of alcohol problems. In this review, we first describe sleep and circadian changes during adolescence and young adulthood. Second, we explain how these sleep/circadian changes intersect with onset and escalation of alcohol use. Third, we briefly note how alcohol use (whether acute or chronic) affects sleep and circadian rhythms. Finally, we articulate a conceptual model containing two mechanistic pathways-broadly positive and negative reinforcement-linking sleep/circadian factors to alcohol involvement before listing key areas we believe are ripe for further inquiry.
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Affiliation(s)
- Brant P Hasler
- University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
| | - Sarah L Pedersen
- University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
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110
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Liu J, Cai W, Zhao M, Cai W, Sui F, Hou W, Wang H, Yu D, Yuan K. Reduced resting-state functional connectivity and sleep impairment in abstinent male alcohol-dependent patients. Hum Brain Mapp 2019; 40:4941-4951. [PMID: 31379038 PMCID: PMC6865575 DOI: 10.1002/hbm.24749] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Revised: 07/21/2019] [Accepted: 07/24/2019] [Indexed: 01/17/2023] Open
Abstract
Alcohol dependence is associated with poor sleep quality, which has both been implicated with thalamocortical circuits function. To identify the possible roles of these circuits in the alcohol-sleep association, we investigated the volume of both left and right thalamus and corresponding resting-state functional connectivity (RSFC) differences between 15 alcohol-dependent patients (AD) and 15 healthy controls (HC) male participants. The neuroimaging findings were then correlated with clinical variables, that is, Alcohol Use Disorders Identification Test (AUDIT) and Pittsburgh Sleep Quality Index (PSQI). Additionally, mediation analysis was carried out to test whether the thalamocortical RSFC mediates the relationship between drinking behavior and sleep impairments in AD when applicable. We observed a significant positive correlation between AUDIT score and PSQI score in AD. Compared with HC, AD showed reduced RSFC between the left thalamus and medial prefrontal cortex (mPFC), orbitofrontal cortex, anterior cingulate cortex (ACC), and right caudate. We also observed a negative correlation between RSFC of the left thalamus-mPFC and PSQI score in AD. More importantly, the left thalamus-mPFC RSFC strength mediated the relationship between AUDIT score and PSQI score in AD. No significant difference was detected in the normalized volume of both left and right thalamus, and volumes were not significantly correlated with clinical variables. Our results demonstrate that AD show abnormal interactions within thalamocortical circuits in association with drinking behaviors and sleep impairments. It is hoped that our study focusing on thalamocortical circuits could provide new information on potential novel therapeutic targets for treatment of sleep impairment in alcohol-dependent patients.
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Affiliation(s)
- Jingjing Liu
- School of Life Science and Technology, Xidian University, Xi'an, Shaanxi, People's Republic of China.,Engineering Research Center of Molecular and Neuro Imaging Ministry of Education, Xi'an, People's Republic of China
| | - Wanye Cai
- School of Life Science and Technology, Xidian University, Xi'an, Shaanxi, People's Republic of China.,Engineering Research Center of Molecular and Neuro Imaging Ministry of Education, Xi'an, People's Republic of China
| | - Meng Zhao
- School of Life Science and Technology, Xidian University, Xi'an, Shaanxi, People's Republic of China.,Engineering Research Center of Molecular and Neuro Imaging Ministry of Education, Xi'an, People's Republic of China
| | - Wenlong Cai
- Xilinguole Meng Mongolian General Hospital, Xilinhaote, Inner Mongolian, People's Republic of China
| | - Feng Sui
- Xilinguole Meng Mongolian General Hospital, Xilinhaote, Inner Mongolian, People's Republic of China
| | - Wenbao Hou
- Xilinguole Meng Mongolian General Hospital, Xilinhaote, Inner Mongolian, People's Republic of China
| | - Hongde Wang
- Xilinguole Meng Mongolian General Hospital, Xilinhaote, Inner Mongolian, People's Republic of China
| | - Dahua Yu
- Inner Mongolia Key Laboratory of Pattern Recognition and Intelligent Image Processing, School of Information Engineering, Inner Mongolia University of Science and Technology, Baotou, Inner Mongolia, People's Republic of China
| | - Kai Yuan
- School of Life Science and Technology, Xidian University, Xi'an, Shaanxi, People's Republic of China.,Engineering Research Center of Molecular and Neuro Imaging Ministry of Education, Xi'an, People's Republic of China.,Inner Mongolia Key Laboratory of Pattern Recognition and Intelligent Image Processing, School of Information Engineering, Inner Mongolia University of Science and Technology, Baotou, Inner Mongolia, People's Republic of China.,Guangxi Key Laboratory of Multi-Source Information Mining and Security, Guangxi Normal University, Guilin, People's Republic of China
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111
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Gender differences in the bidirectional relationship between alcohol consumption and sleeplessness: the Tromsø study. BMC Public Health 2019; 19:444. [PMID: 31035989 PMCID: PMC6489301 DOI: 10.1186/s12889-019-6801-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Accepted: 04/11/2019] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND The degree to which the relationship between alcohol use and sleeplessness is unidirectional or reciprocal is unclear due to great variation among the results of previous studies. The aim of the present study was to investigate if the relationship between alcohol use and sleeplessness is bidirectional by exploring how the change in and stability of alcohol use were related to sleeplessness, and vice versa, how the change in and stability of sleeplessness were related to alcohol use, in a longitudinal study spanning 13 years. METHOD Data were collected from 9941 adults who participated in two waves (T1: 1994-1995, and T2: 2007-2008) of the Tromsø Study, a Norwegian general population health study. Alcohol use was measured by questions asking about the frequency of drinking, amounts of alcohol normally consumed and the frequency of binge drinking, whereas sleeplessness was measured by one item asking about the frequency of experiencing sleeplessness. Variables representing change in and stability of consumption of alcohol and sleeplessness from T1 to T2 were created. Logistic regression analyses, stratified by gender, were used to analyze the data. RESULTS Men reporting stable high (OR = 2.11, p. < .001) or increasing (OR = 1.94, p. < .01) consumption of alcohol from T1 to T2 had a significantly higher risk of reporting sleeplessness at T2. Likewise, men experiencing stable (OR = 1.84, p. < .01) or increasing (OR = 1.78, p. < .001) sleeplessness from T1 to T2 had a significantly higher risk of reporting high consumption of alcohol at T2. No significant effects were detected among women. CONCLUSION The findings indicate a bidirectional relationship between high consumption of alcohol and sleeplessness only among men. Thus, healthcare professionals ought to be informed about the health risks associated with excessive drinking and struggling with sleeplessness, especially in men.
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112
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Chakravorty S, Morales KH, Arnedt JT, Perlis ML, Oslin DW, Findley JC, Kranzler HR. Cognitive Behavioral Therapy for Insomnia in Alcohol-Dependent Veterans: A Randomized, Controlled Pilot Study. Alcohol Clin Exp Res 2019; 43:1244-1253. [PMID: 30912860 DOI: 10.1111/acer.14030] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Accepted: 03/18/2019] [Indexed: 01/22/2023]
Abstract
BACKGROUND Insomnia is highly prevalent in individuals recovering from alcohol dependence (AD) and increases their risk of relapse. Two studies evaluating cognitive behavior therapy for insomnia (CBT-I) have demonstrated its efficacy in non-Veterans recovering from AD. The aim of this study was to extend these findings in an 8-week trial of CBT-I in Veterans. METHODS Veterans recovering from AD were randomly assigned to 8 weeks of treatment with CBT-I (N = 11) or a Monitor-Only (MO; N = 11) condition and were evaluated 3 (N = 21/22) and 6 months posttreatment (N = 18/22). The primary outcome measure was the Insomnia Severity Index (ISI) score. Secondary outcome measures were sleep diary measures, percent days abstinent (PDA), and scores on the Dysfunctional Beliefs and Attitudes About Sleep Scale (DBAS), Sleep Hygiene Index (SHI), Penn Alcohol Craving Scale (PACS), Quick Inventory of Depressive Symptoms (QIDS), State-Trait Anxiety Inventory-Trait (STAI-T) scale, and Short Form 12-item (SF-12). Mixed-effects regression models, adjusted for race, evaluated differences in outcomes between the groups over a 6-month period (clinicaltrials.gov identifier = NCT01603381). RESULTS Subjects were male, aged 54.5 (SD = 6.9) years, and had 26.4 (SD = 26.3) days of abstinence before their baseline evaluation. CBT-I produced a significantly greater improvement in model-based estimates than MO (mean change at 6 months compared to their baseline) for ISI, sleep latency from a daily sleep diary, DBAS mean score, and SHI total score. PDA and QIDS improved over time, but there was no difference between the groups. PACS, STAI-T, or SF-12 scale did not show any improvement from their baseline scores. CONCLUSIONS CBT-I treatment demonstrated substantial efficacy in reducing insomnia, associated negative cognitions, and improving sleep hygiene in Veterans during early recovery, though it did not reduce drinking behavior.
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Affiliation(s)
- Subhajit Chakravorty
- Corporal Michael J. Crescenz VA Medical Center , Philadelphia, Pennsylvania.,Perelman School of Medicine , Philadelphia, Pennsylvania
| | | | - J Todd Arnedt
- University of Michigan Medical School , Ann Arbor, Michigan
| | | | - David W Oslin
- Corporal Michael J. Crescenz VA Medical Center , Philadelphia, Pennsylvania.,Perelman School of Medicine , Philadelphia, Pennsylvania
| | - James C Findley
- Penn Sleep Center , Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Henry R Kranzler
- Corporal Michael J. Crescenz VA Medical Center , Philadelphia, Pennsylvania.,Perelman School of Medicine , Philadelphia, Pennsylvania
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113
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Alcohol and sleep-related problems. Curr Opin Psychol 2019; 30:117-122. [PMID: 31128400 DOI: 10.1016/j.copsyc.2019.03.007] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2018] [Revised: 02/16/2019] [Accepted: 03/07/2019] [Indexed: 11/20/2022]
Abstract
Alcohol is one of the most commonly used psychoactive substances in the community. Many individuals use alcohol for its sleep-promoting effects. Nonetheless, alcohol disrupts sleep through multiple mechanisms, such as disrupting electrophysiologic sleep architecture, triggering insomnia, and contributing to abnormalities of circadian rhythms and short sleep duration (SSD) in cross-sectional studies. Alcohol also increases breathing-related sleep events such as snoring and oxygen desaturation, especially in those with pre-existing problems. Emerging data demonstrate that insomnia may co-exist with SSD and circadian abnormalities. Future studies should unravel these tentative associations in individuals who misuse alcohol.
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114
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Laniepce A, Segobin S, Lannuzel C, Boudehent C, Ritz L, Urso L, Vabret F, Eustache F, Beaunieux H, Rauchs G, Pitel A. Neuropsychological and Neuroimaging Examinations of Self‐Reported Sleep Quality in Alcohol Use Disorder With and Without Korsakoff's Syndrome. Alcohol Clin Exp Res 2019; 43:952-964. [DOI: 10.1111/acer.13997] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Accepted: 02/27/2019] [Indexed: 12/13/2022]
Affiliation(s)
- Alice Laniepce
- U1077, CHU de Caen GIP Cyceron, Neuropsychologie et Imagerie de la Mémoire Humaine Normandy Univ, UNICAEN, PSL Université EPHE INSERM Caen France
| | - Shailendra Segobin
- U1077, CHU de Caen GIP Cyceron, Neuropsychologie et Imagerie de la Mémoire Humaine Normandy Univ, UNICAEN, PSL Université EPHE INSERM Caen France
| | - Coralie Lannuzel
- U1077, CHU de Caen GIP Cyceron, Neuropsychologie et Imagerie de la Mémoire Humaine Normandy Univ, UNICAEN, PSL Université EPHE INSERM Caen France
| | - Céline Boudehent
- U1077, CHU de Caen GIP Cyceron, Neuropsychologie et Imagerie de la Mémoire Humaine Normandy Univ, UNICAEN, PSL Université EPHE INSERM Caen France
- Addiction Department Centre Hospitalier Universitaire de Caen Caen France
| | - Ludivine Ritz
- U1077, CHU de Caen GIP Cyceron, Neuropsychologie et Imagerie de la Mémoire Humaine Normandy Univ, UNICAEN, PSL Université EPHE INSERM Caen France
| | - Laurent Urso
- Addiction Department Centre Hospitalier de Roubaix Roubaix France
| | - François Vabret
- U1077, CHU de Caen GIP Cyceron, Neuropsychologie et Imagerie de la Mémoire Humaine Normandy Univ, UNICAEN, PSL Université EPHE INSERM Caen France
- Addiction Department Centre Hospitalier Universitaire de Caen Caen France
| | - Francis Eustache
- U1077, CHU de Caen GIP Cyceron, Neuropsychologie et Imagerie de la Mémoire Humaine Normandy Univ, UNICAEN, PSL Université EPHE INSERM Caen France
| | - Hélène Beaunieux
- U1077, CHU de Caen GIP Cyceron, Neuropsychologie et Imagerie de la Mémoire Humaine Normandy Univ, UNICAEN, PSL Université EPHE INSERM Caen France
| | - Géraldine Rauchs
- U1077, CHU de Caen GIP Cyceron, Neuropsychologie et Imagerie de la Mémoire Humaine Normandy Univ, UNICAEN, PSL Université EPHE INSERM Caen France
| | - Anne‐Lise Pitel
- U1077, CHU de Caen GIP Cyceron, Neuropsychologie et Imagerie de la Mémoire Humaine Normandy Univ, UNICAEN, PSL Université EPHE INSERM Caen France
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Chen Y, Li S. The Relationship Between Workplace Ostracism and Sleep Quality: A Mediated Moderation Model. Front Psychol 2019; 10:319. [PMID: 30886594 PMCID: PMC6409495 DOI: 10.3389/fpsyg.2019.00319] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2018] [Accepted: 02/01/2019] [Indexed: 11/28/2022] Open
Abstract
Extant research suggests that workplace ostracism has a detrimental impact on the outcomes of employees. However, very little is known about the impact of workplace ostracism on sleep quality. Therefore, this study aimed to address this gap in the literature. By employing the extended stressor-detachment model, we investigated the mediating role of psychological detachment and the moderating role of coping humor. We used a self-report questionnaire and a time-lagged research design to assess employees' workplace ostracism, coping humor, psychological detachment, and sleep quality. A total of 403 valid questionnaires were obtained from participants in full-time employment in China. As predicted, the results showed that workplace ostracism is negatively associated with psychological detachment, which in turn, impairs sleep quality. We further found that high levels of coping humor buffer the negative effect of workplace ostracism on psychological detachment and sleep quality. In addition, the moderation effect of coping humor on the relationship between workplace ostracism and sleep quality is mediated by psychological detachment. Finally, based upon the results, we discuss the theoretical implications, provide practical proposals for managers and policymakers, and make suggestions for the direction of further research.
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Affiliation(s)
| | - Shuang Li
- School of Management, China University of Mining and Technology, Xuzhou, China
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116
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Ogeil RP, Phillips JG, Savic M, Lubman DI. Sleep- and Wake-Promoting Drugs: Where Are They Being Sourced, and What Is Their Impact? Subst Use Misuse 2019; 54:1916-1928. [PMID: 31282821 DOI: 10.1080/10826084.2019.1609040] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Background: Recent decades have seen both an increased number of shift workers in order to deliver services 24/7, and increased potential for social interactions at all hours of the day. People have sought to engage in strategies, which either promote vigilance or facilitate sleep, with the use of sleep- and wake-promoting drugs representing one strategy. Methods: We investigated use of sleep- and wake-promoting drugs in participants (n = 377) who completed a survey investigating the type and source of sleep- and wake-promoting drugs, and their impact on sleep and performance outcomes. Results: The most commonly reported wake-promoting drugs were amphetamine and dextroamphetamin salts, modafinil, and illicit substances including methamphetamine and cocaine, while the most commonly reported sleep-promoting drugs were benzodiazepines and antihistamines. Use of a sleep-promoting drug in the past month was associated with higher odds of having poorer sleep quality (OR = 3.15) and moderate-high insomnia (OR = 3.30), while use of a wake-promoting drug was associated with poor sleep quality (OR = 3.76), or making a fatigue-related error (OR = 2.65). Conclusions: These findings represent novel data on the use and source of sleep- and wake-promoting- drugs, and suggest that despite their use, poor sleep and performance outcomes persist, likely representing individuals struggling to keep up with the 24/7 world.
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Affiliation(s)
- Rowan P Ogeil
- Eastern Health Clinical School, Monash University , Box Hill, VIC , Australia.,Turning Point, Eastern Health , Richmond , VIC , Australia
| | - James G Phillips
- Psychology Department, Auckland University of Technology , Auckland , New Zealand
| | - Michael Savic
- Eastern Health Clinical School, Monash University , Box Hill, VIC , Australia.,Turning Point, Eastern Health , Richmond , VIC , Australia
| | - Daniel I Lubman
- Eastern Health Clinical School, Monash University , Box Hill, VIC , Australia.,Turning Point, Eastern Health , Richmond , VIC , Australia
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117
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Brooks AT, Tuason RT, Chakravorty S, Raju S, Ritterband LM, Thorndike FP, Wallen GR. Online cognitive behavioral therapy for insomnia (CBT-I) for the treatment of insomnia among individuals with alcohol use disorder: study protocol for a randomized controlled trial. Pilot Feasibility Stud 2018; 4:183. [PMID: 30555713 PMCID: PMC6287341 DOI: 10.1186/s40814-018-0376-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2018] [Accepted: 11/25/2018] [Indexed: 12/16/2022] Open
Abstract
Abstract Alcohol use disorder (AUD) is characterized by problematic drinking that becomes severe. Individuals with AUD often experience insomnia and other sleep disturbances at various phases of recovery. Cognitive behavioral therapy for insomnia (CBT-I) is an efficacious non-pharmacological treatment for insomnia and is recommended as a first-line treatment for adults with chronic insomnia. Internet-based CBT-I could play a key role in the dissemination of this behavioral sleep intervention, given the paucity of trained clinicians able to provide CBT-I in person and other logistical/cost concerns. SHUTi (Sleep Healthy Using The Internet) is the most tested and empirically-sound Internet intervention for insomnia. Despite the promise of Internet-based CBT-I interventions, to date, no randomized controlled trials (RCTs) exist examining the feasibility/efficacy of an Internet-based CBT-I program among treatment-seeking individuals recovering from AUD. This is a two-phase RCT assessing feasibility/acceptability and efficacy of the SHUTi program among individuals with AUD in recovery with insomnia. Phase I will focus on assessing the feasibility and acceptability of program delivery and data collection (n = 10). Phase II will be an RCT powered to examine preliminary intervention efficacy (n = 30 per group). Participants for this study must meet criteria for “moderate to severe” insomnia. Individuals randomized to the intervention group will receive the SHUTi intervention (initiated while inpatient and completed while outpatient), and individuals randomized to the control group will receive an educational web-based program. The goals of the study are as follows: (1) assess the feasibility and acceptability of Internet-based CBT-I among individuals with AUD in recovery with insomnia (phase I), (2) compare the preliminary efficacy of CBT-I versus control group with respect to primary and secondary outcome variables (phase II), and (3) explore specific domains associated with improved outcomes, e.g., demographic, psychiatric, and drinking-related factors (phase II). Primary outcome measures include changes in insomnia severity over time and changes in actigraphy-recorded sleep efficiency over time. Trial registration NCT#03493958; registered 1 June 2018. Electronic supplementary material The online version of this article (10.1186/s40814-018-0376-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Alyssa T Brooks
- 1National Institutes of Health Clinical Center, Bethesda, USA
| | - Ralph T Tuason
- 1National Institutes of Health Clinical Center, Bethesda, USA
| | - Subhajit Chakravorty
- 2Perelman School of Medicine, Department of Psychiatry, University of Pennsylvania, Philadelphia, USA
| | - Shravya Raju
- 1National Institutes of Health Clinical Center, Bethesda, USA
| | - Lee M Ritterband
- Department of Psychiatry and Neurobehavioral Sciences, Center for Behavioral Health and Technology, PO Box 801075, Charlottesville, VA 22908 USA
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Campbell EJ, Marchant NJ, Lawrence AJ. A sleeping giant: Suvorexant for the treatment of alcohol use disorder? Brain Res 2018; 1731:145902. [PMID: 30081035 DOI: 10.1016/j.brainres.2018.08.005] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2018] [Revised: 07/23/2018] [Accepted: 08/01/2018] [Indexed: 01/12/2023]
Abstract
There are currently 3 FDA approved treatments for alcohol use disorder (AUD) in the USA, opioid receptor antagonists such as naltrexone, disulfiram and acamprosate. To date, these have been largely inadequate at preventing relapse at a population level and this may be because they only target certain aspects of AUD. Recently, suvorexant, a dual orexin receptor antagonist, has been FDA approved for the treatment of insomnia. Importantly, sleep disruptions occur during both acute and prolonged alcohol exposure and sleep deprivation is a potent factor promoting relapse to alcohol use. In this mini review article, we explore the therapeutic potential of suvorexant for the treatment of AUD. In particular, we highlight that in addition to altering the motivational properties of alcohol, suvorexant may also address key physiological components associated with alcohol withdrawal and abstinence, such as sleep disruptions, which should in turn help reduce or prevent relapse.
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Affiliation(s)
- Erin J Campbell
- The Florey Institute of Neuroscience and Mental Health, Parkville, Victoria 3052, Australia; Florey Department of Neuroscience and Mental Health, The University of Melbourne, Victoria 3010, Australia
| | - Nathan J Marchant
- The Florey Institute of Neuroscience and Mental Health, Parkville, Victoria 3052, Australia; Florey Department of Neuroscience and Mental Health, The University of Melbourne, Victoria 3010, Australia; Department of Anatomy & Neurosciences, VU University Medical Center, Amsterdam, The Netherlands
| | - Andrew J Lawrence
- The Florey Institute of Neuroscience and Mental Health, Parkville, Victoria 3052, Australia; Florey Department of Neuroscience and Mental Health, The University of Melbourne, Victoria 3010, Australia.
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Chakravorty S, Chaudhary NS, Morales K, Grandner MA, Oslin DW. Is family history of alcohol dependence a risk factor for disturbed sleep in alcohol dependent subjects? Drug Alcohol Depend 2018; 188:311-317. [PMID: 29843109 PMCID: PMC7486904 DOI: 10.1016/j.drugalcdep.2018.04.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2017] [Revised: 04/08/2018] [Accepted: 04/10/2018] [Indexed: 11/24/2022]
Abstract
BACKGROUND Disturbed sleep and a family history of alcohol dependence (AD) are risk factors for developing AD, yet the underlying relationship between them is unclear among individuals with AD. Understanding these inherited associations will help us not only identify risk for development of these comorbid disorders, but also individualize treatment at this interface. We evaluated whether a first-degree family history of AD (FH+) was a risk factor for sleep continuity disturbance in patients with AD. We also evaluated whether alcohol use or mood disturbance moderated the relationship between FH and sleep. METHODS We analyzed cross-sectional baseline data from an alcohol clinical trial in a sample of individuals with AD (N = 280). Their family history of AD among nuclear family members, sleep complaints, alcohol use (over the last 90 days), and mood disturbance were assessed using the Family History Interview for Substance and Mood Disorders, Medical Outcomes Study Sleep Scale, Time Line Follow-Back Interview, and Profile of Mood States-Short Form, respectively. RESULTS A FH + status (65% of subjects) was significantly associated with lower model estimated mean sleep adequacy (β = - 7.05, p = 0.02) and sleep duration (β = - 0.38, p = 0.04) scale scores. FH was not associated with sleep disturbance scale. No significant moderating effect involving alcohol use or mood disturbance was seen. CONCLUSION Family history of AD is a unique risk factor for sleep complaints in AD. Non-restorative sleep and sleep duration may be noteworthy phenotypes to help probe for underlying genotypic polymorphisms in these comorbid disorders.
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Affiliation(s)
- Subhajit Chakravorty
- Cpl. Michael J. Crescenz VA Medical Center, 3900 Woodland Ave., Philadelphia, PA 19104, USA; Perelman School of Medicine, University of Pennsylvania, 3400 Civic Center Blvd., Philadelphia, PA 19104, USA.
| | | | | | | | - David W. Oslin
- Cpl. Michael J. Crescenz VA Medical Center, Philadelphia, PA 19104;,Perelman School of Medicine, Philadelphia, PA 19104
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120
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Chakravorty S, Vandrey RG, He S, Stein MD. Sleep Management Among Patients with Substance Use Disorders. Med Clin North Am 2018; 102:733-743. [PMID: 29933826 PMCID: PMC6289280 DOI: 10.1016/j.mcna.2018.02.012] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Sleep and substance use disorders commonly co-occur. Insomnia is commonly associated with use and withdrawal from substances. Circadian rhythm abnormalities are being increasingly linked with psychoactive substance use. Other sleep disorders, such as sleep-related breathing disorder, should be considered in the differential diagnosis of insomnia, especially in those with opioid use or alcohol use disorder. Insomnia that is brief or occurs in the context of active substance use is best treated by promoting abstinence. A referral to a sleep medicine clinic should be considered for those with chronic insomnia or when another intrinsic sleep disorder is suspected.
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Affiliation(s)
- Subhajit Chakravorty
- Department of Psychiatry, Perelman School of Medicine, Corporal Michael J. Crescenz VA Medical Center, MIRECC, 2nd Floor, Postal Code 116, 3900 Woodland Avenue, Philadelphia, PA 19104, USA.
| | - Ryan G Vandrey
- Behavioral Pharmacology Research Unit, Johns Hopkins University School of Medicine, 5510 Nathan Shock Drive, Baltimore, MD 21224, USA
| | - Sean He
- Post-baccalaureate studies program, College of Liberal Arts and Professional Studies, University of Pennsylvania, 3440 Market Street Suite 100, Philadelphia, PA 19104, USA; Department of R & D, Corporal Michael J. Crescenz VA Medical Center, 3900 Woodland Avenue, Philadelphia, PA 19104, USA
| | - Michael D Stein
- Department of Health Law, Policy and Management, Boston University School of Public Health, 715 Albany Street, Boston, MA 02118, USA
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Ehlers CL, Wills D, Gilder DA. A history of binge drinking during adolescence is associated with poorer sleep quality in young adult Mexican Americans and American Indians. Psychopharmacology (Berl) 2018; 235:1775-1782. [PMID: 29589068 PMCID: PMC6013062 DOI: 10.1007/s00213-018-4889-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2017] [Accepted: 03/16/2018] [Indexed: 12/17/2022]
Abstract
RATIONALE Binge drinking during adolescence is common, and adolescents and young adults with alcohol problems may also have sleep difficulties. However, few studies have documented the effects of a history of adolescent binge drinking on sleep in young adulthood in high-risk minority populations. OBJECTIVES To quantify sleep disturbance, as indexed by the Pittsburgh Sleep Quality Index (PSQI), in a sample of young adult Mexican American and American Indian men and women (18-30 years, n = 800) with and without a history of alcohol binge drinking during adolescence, controlling for age, gender, and race. RESULTS Gender was found to affect PSQI responses with females reporting waking up at night, having more bad dreams, and later habitual bedtimes than males, and males reporting more problems with breathing and snoring. Increasing age was associated with snoring or coughing, less hours spent in bed, and later evening bedtimes. Race also influenced the PSQI with American Indians reporting longer sleep latencies and sleep durations, more hours spent in bed, and more trouble with coughing and snoring than Mexican Americans, and Mexican Americans reporting later bedtimes. A history of adolescent regular binge drinking was associated with longer sleep latencies, more problems with breathing, bad dreams, and an overall higher PSQI total score, when controlling for age, race, and gender. CONCLUSIONS This report suggests, like what has been found in young adults in general population samples, that binge drinking during adolescence is associated with deleterious consequences on sleep quality in young adulthood in these high-risk and understudied ethnic groups.
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Affiliation(s)
- Cindy L Ehlers
- Department of Neurosciences, The Scripps Research Institute, 10550 North Torrey Pines Road, SP30-1501, La Jolla, CA, 92037, USA.
| | - Derek Wills
- Department of Neurosciences, The Scripps Research Institute, 10550 North Torrey Pines Road, SP30-1501, La Jolla, CA, 92037, USA
| | - David A Gilder
- Department of Neurosciences, The Scripps Research Institute, 10550 North Torrey Pines Road, SP30-1501, La Jolla, CA, 92037, USA
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122
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Ehlers CL, Sanchez-Alavez M, Wills D. Effect of gabapentin on sleep and delta and theta EEG power in adult rats exposed to chronic intermittent ethanol vapor and protracted withdrawal during adolescence. Psychopharmacology (Berl) 2018; 235:1783-1791. [PMID: 29589069 PMCID: PMC5949268 DOI: 10.1007/s00213-018-4888-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Accepted: 03/16/2018] [Indexed: 01/22/2023]
Abstract
RATIONALE Adolescents and young adults with alcohol problems may also have sleep difficulties. However, whether these sleep problems are a result of a history of drinking or arise due to other comorbid disorders is difficult to disentangle in human studies. Additionally, the mechanisms underlying adolescent alcohol-induced sleep disturbances and potential targets for therapy also remain under-investigated. Recent clinical trials have demonstrated that the anticonvulsant and analgesic drug gabapentin may have therapeutic value in normalizing sleep quality in adult recovering alcoholics, yet its potential for the treatment of adolescent sleep disturbances has not been investigated. OBJECTIVES This study sought to evaluate the effects of a history of 5 weeks of chronic intermittent ethanol vapor exposure, administered during adolescence (AIE), on EEG sleep, in young adult rats (n = 29). The ability of two doses of gabapentin (30, 120 mg/kg) to modify sleep and slow wave activity were also investigated in these young adult rats exposed to alcohol vapor during adolescence. RESULTS Adolescent vapor exposure in the rat was found to result in deficits in delta (1-4 Hz) and theta (4-8 Hz) power during slow wave sleep. Administration of gabapentin caused a "normalization" of the delta power deficits but did not affect theta power. CONCLUSIONS This report suggests that the potential mechanisms and therapeutic targets for sleep disturbance associated with adolescent alcohol exposure can be studied in preclinical models and that gabapentin may show partial efficacy in ameliorating these sleep deficits.
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Affiliation(s)
- Cindy L Ehlers
- Department of Neurosciences, The Scripps Research Institute, 10550 North Torrey Pines Road, SP30-1501, La Jolla, CA, 92037, USA.
| | - Manuel Sanchez-Alavez
- Department of Neurosciences, The Scripps Research Institute, 10550 North Torrey Pines Road, SP30-1501, La Jolla, CA, 92037, USA
| | - Derek Wills
- Department of Neurosciences, The Scripps Research Institute, 10550 North Torrey Pines Road, SP30-1501, La Jolla, CA, 92037, USA
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124
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Perney P, Lehert P. Insomnia in Alcohol-Dependent Patients: Prevalence, Risk Factors and Acamprosate Effect: An Individual Patient Data Meta-Analysis. Alcohol Alcohol 2018; 53:611-618. [DOI: 10.1093/alcalc/agy013] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Indexed: 11/12/2022] Open
Affiliation(s)
- Pascal Perney
- Service d’Addictologie, Hôpital Caremeau, Place du Pr Debré, Nîmes, France
- université Montpellier 1, 2 rue de l'école de Médecine, Montpellier, France
- CESP, UMR 1018, INSERM, UPS, UVSQ. P. Descartes. Hôpital Paul Brousse – Bat 15/16 – 16 avenue PV Couturier 6 Villejuif Cedex, France
| | - Philippe Lehert
- Statistics Department, Faculty of Economics, University of Louvain, 181 chaussée de Binche, Mons, Belgium
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Jehan S, Myers AK, Zizi F, Pandi-Perumal SR, Jean-Louis G, Singh N, Ray J, McFarlane SI. Sleep health disparity: the putative role of race, ethnicity and socioeconomic status. SLEEP MEDICINE AND DISORDERS : INTERNATIONAL JOURNAL 2018; 2:127-133. [PMID: 31179440 PMCID: PMC6553614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Sleep plays a pivotal role in both physical and mental health. Sleep quality can be affected by many socio demographic factors, such as race and/or ethnicity, as well as socio economic status (SES). Chronic sleep deprivation is associated with unhealthy behaviors such as alcohol abuse and also places individuals at risk for chronic diseases including obesity, cardiovasculardisease (CVD), depression, and/or anxiety. This review explores the common socio demographic factors and SES that can lead to sleep disturbances. Among these factors are shift work, poor dietary habits, smoking and alcohol abuse. Such factors need to be considered by health care providers in the clinical assessment and management plans of patients with sleep disorders.
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Affiliation(s)
- Shazia Jehan
- Department of Population Health, New York University School of Medicine, USA
| | - Alyson K Myers
- Department of Medicine, North Shore University Hospital, USA
| | - Ferdinand Zizi
- Department of Medicine, North Shore University Hospital, USA
| | | | - Girardin Jean-Louis
- Department of Population Health, New York University School of Medicine, USA
| | - Navneet Singh
- Department of Medicine, SUNY Downstate Medical Center, USA
| | - Justina Ray
- Department of Medicine, SUNY Downstate Medical Center, USA
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Melroy-Greif WE, Gizer IR, Wilhelmsen KC, Ehlers CL. Genetic Influences on Evening Preference Overlap with Those for Bipolar Disorder in a Sample of Mexican Americans and American Indians. Twin Res Hum Genet 2017; 20:499-510. [PMID: 29192581 PMCID: PMC6013261 DOI: 10.1017/thg.2017.62] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Diurnal preference (e.g., being an owl or lark) has been associated with several psychiatric disorders including bipolar disorder (BP), major depressive disorder, and substance use disorders. Previous large-scale genome-wide association studies (GWAS) aimed at identifying genetic influences on diurnal preference have exclusively included subjects of European ancestry. This study examined the genetic architecture of diurnal preference in two minority samples: a young adult sample of Mexican Americans (MAs), and a family-based sample of American Indians (AIs). Typed or imputed variants from exome chip data from the MA sample and low pass whole-genome sequencing from the AI cohort were analyzed using a mixed linear model approach for association with being an owl, as defined by a usual bedtime after 23:00 hrs. Genetic risk score (GRS) profiling detected shared genetic risk between evening preference and related disorders. Four variants in KIAA1549 like (KIAA1549L), a gene previously associated with attempted suicide in bipolar patients, were suggestively associated with being an owl at p < 1.82E-05; post hoc analyses showed the top variant trending in both the MA and AI cohorts at p = 2.50E-05 and p = .030, respectively. Variants associated with BP at p < .03 from the Psychiatric Genomics Consortium nominally predicted being an owl in the MA/AI cohort at p = .012. This study provides some additional evidence that genetic risk factors for BP also confer risk for being an owl in MAs/AIs and that evening preference may be a useful endophenotype for future studies of BP.
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Affiliation(s)
| | - Ian R. Gizer
- Department of Psychological Sciences, University of Missouri, Columbia, MO 65211, USA
| | - Kirk C. Wilhelmsen
- Renaissance Computing Institute (RENCI), Chapel Hill, NC 27517, USA
- Departments of Genetics and Neurology, University of North Carolina, Chapel Hill, NC 27599, USA
| | - Cindy L. Ehlers
- Department of Neuroscience, The Scripps Research Institute, La Jolla, CA 92037, USA
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Insomnia treatment in the context of alcohol use disorder: A systematic review and meta-analysis. Drug Alcohol Depend 2017; 181:200-207. [PMID: 29096290 PMCID: PMC5683932 DOI: 10.1016/j.drugalcdep.2017.09.029] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Revised: 08/28/2017] [Accepted: 09/22/2017] [Indexed: 11/20/2022]
Abstract
PURPOSE To determine the efficacy of behavioral and pharmacological interventions for insomnia among individuals with alcohol use disorder (AUD). PROCEDURES Comprehensive literature searches of psychological, medical, and educational databases were conducted through October 2016. Eligible studies evaluated the efficacy of an insomnia intervention, included a comparison condition, sampled individuals with AUD and either insomnia disorder or complaints of insomnia, assessed sleep-related outcomes, and provided relevant statistics to calculate between-group effect sizes. Effect sizes were estimated for sleep quality, days of alcohol abstinence, and symptoms of depression. Type of intervention (behavioral versus pharmacological) was tested as a moderator of intervention efficacy. MAIN FINDINGS Nine studies met eligibility criteria and were included in the final review and meta-analysis. Random-effects models indicated that intervention participants reported greater improvements in sleep quality (d+=0.62, 95% CI=0.28, 0.97) and symptoms of depression (d+=0.52, 95% CI=0.06, 0.98) than control participants. Participants reported significantly greater improvements in sleep quality in response to behavioral (d+=1.20, 95% CI=0.70, 1.70) as opposed to pharmacological (d+=0.43, 95% CI=0.19, 0.67) interventions. Behavioral (d+=0.74, 95% CI=0.31, 1.18) and pharmacological (d+=0.08, 95% CI=-0.64, 0.78) interventions did not have significantly different effects on depressive symptoms. Neither behavioral nor pharmacological interventions improved rates of alcohol abstinence. CONCLUSIONS Insomnia interventions improve sleep quality and reduce symptoms of depression among individuals with comorbid AUD. Given the methodological weaknesses of studies reviewed, additional research is needed to determine the efficacy of insomnia treatment in improving rates of alcohol relapse within this population.
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Abstract
Mild traumatic brain injury (mTBI) frequently challenges the integrity of sleep function by affecting multiple brain areas implicated in controlling the switch between wakefulness and sleep and those involved in circadian and homeostatic processes; the malfunction of each causes a variety of disorders. In this review, we discuss recent data on the dynamics between disorders of sleep and mental/psychiatric disorders in persons with mTBI. This analysis sets the stage for understanding how a variety of physiological, emotional and environmental influences affect sleep and mental activities after injury to the brain. Consideration of the intricate links between sleep and mental functions in future research can increase understanding on the underlying mechanisms of sleep-related and psychiatric comorbidity in mTBI.
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Jimenez VA, Grant KA. Studies using macaque monkeys to address excessive alcohol drinking and stress interactions. Neuropharmacology 2017; 122:127-135. [PMID: 28347838 DOI: 10.1016/j.neuropharm.2017.03.027] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2017] [Revised: 03/20/2017] [Accepted: 03/23/2017] [Indexed: 12/15/2022]
Abstract
The use of non-human primates (NHPs) in studies of volitional, oral self-administration of alcohol can help address the complex interplay between stress and excessive alcohol consumption. There are aspects to brain, endocrine and behavior of NHPs, particularly macaques, that provide a critical translational link towards understanding the risks and consequences of alcohol use disorders (AUDs) in humans. These include wide individual differences in escalating daily alcohol intake, accurate measures of hypothalamic-pituitary-adrenal (HPA) axis hormonal interactions, neuroanatomical specificity of synaptic adaptations to chronic alcohol, genetic similarities to humans, and the ability to conduct in vivo brain imaging. When placed in a framework that alcohol addiction is a sequence of dysregulations in motivational circuitry associated with severity of AUD, the NHP can provide within-subject information on both risks for and consequences of repeatedly drinking to intoxication. Notably, long-term adaptations in neurocircuitry that mediate behavioral reinforcement, stress responses and executive functions are possible with NHPs. We review here the substantial progress made using NHPs to address the complex relationship between alcohol and stress as risk factors and consequences of daily drinking to intoxication. This review also highlights areas where future studies of brain and HPA axis adaptations are needed to better understand the mechanisms involved in stress leading to excessive alcohol consumption. This article is part of the Special Issue entitled "Alcoholism".
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Affiliation(s)
- Vanessa A Jimenez
- Oregon Health & Science University, Department of Behavioral Neuroscience, Portland, OR, USA
| | - Kathleen A Grant
- Oregon Health & Science University, Department of Behavioral Neuroscience, Portland, OR, USA; Oregon National Primate Research Center, Division of Neuroscience, Beaverton, OR, USA.
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Alcohol Consumption in Diabetic Patients with Nonalcoholic Fatty Liver Disease. Can J Gastroenterol Hepatol 2017; 2017:7927685. [PMID: 29226116 PMCID: PMC5687130 DOI: 10.1155/2017/7927685] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2017] [Revised: 09/28/2017] [Accepted: 10/15/2017] [Indexed: 02/08/2023] Open
Abstract
AIM To examine the association between lifetime alcohol consumption and significant liver disease in type 2 diabetic patients with NAFLD. METHODS A cross-sectional study assessing 151 patients with NAFLD at risk of clinically significant liver disease. NAFLD fibrosis severity was classified by transient elastography; liver stiffness measurements ≥8.2 kPa defined significant fibrosis. Lifetime drinking history classified patients into nondrinkers, light drinkers (always ≤20 g/day), and moderate drinkers (any period with intake >20 g/day). RESULT Compared with lifetime nondrinkers, light and moderate drinkers were more likely to be male (p = 0.008) and to be Caucasian (p = 0.007) and to have a history of cigarette smoking (p = 0.000), obstructive sleep apnea (p = 0.003), and self-reported depression (p = 0.003). Moderate drinkers required ≥3 hypoglycemic agents to maintain diabetic control (p = 0.041) and fibrate medication to lower blood triglyceride levels (p = 0.044). Compared to lifetime nondrinkers, light drinkers had 1.79 (95% CI: 0.67-4.82; p = 0.247) and moderate drinkers had 0.91 (95% CI: 0.27-3.10; p = 0.881) times the odds of having liver stiffness measurements ≥8.2 kPa (adjusted for age, gender, and body mass index). CONCLUSIONS In diabetic patients with NAFLD, light or moderate lifetime alcohol consumption was not significantly associated with liver fibrosis. The impact of lifetime alcohol intake on fibrosis progression and diabetic comorbidities, in particular obstructive sleep apnea and hypertriglyceridemia, requires further investigation.
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