Alcohol Dependence and Its Relationship With Insomnia and Other Sleep Disorders

Abstract

Sleep-related complaints are widely prevalent in those with alcohol dependence (AD). AD is associated not only with insomnia, but also with multiple sleep-related disorders as a growing body of literature has demonstrated. This article will review the various aspects of insomnia associated with AD. In addition, the association of AD with other sleep-related disorders will be briefly reviewed. The association of AD with insomnia is bidirectional in nature. The etiopathogenesis of insomnia has demonstrated multiple associations and is an active focus of research. Treatment with cognitive behavioral therapy for insomnia is showing promise as an optimal intervention. In addition, AD may be associated with circadian abnormalities, short sleep duration, obstructive sleep apnea, and sleep-related movement disorder. The burgeoning knowledge on insomnia associated with moderate-to-severe alcohol use disorder has expanded our understanding of its underlying neurobiology, clinical features, and treatment options.

Keywords: Alcohol; Alcoholism; Sleep; Sleep Initiation and Maintenance Disorders.

Figure 1.

Manuscript selection process for the current review

Figure 2.. A conceptual model of insomnia in alcohol dependence

Legend: ¹ Predisposing Factors: Familial AD, genetic (clock gene polymorphism), chronotype (evening type), childhood trauma, childhood sleep problems; ² Precipitating Factors: Acute life events or psychosocial stressors; ³ Perpetuating Factors: Compensatory behaviors that are adopted by the individual in order to cope with the insomnia, but that actually reinforce the sleep problem. These factors can include the practice of non-sleep behaviors in the bedroom, staying in bed while awake, watching television or reading while in bed, and spending excessive amounts of time in bed (Spielman et al., 1987).