Leveraging Ecological Momentary Assessment to Examine Bi-directional Associations Between Sleep Quality, Adolescent/Young Adult Alcohol Craving and Use
- PMID: 37061844
- PMCID: PMC10312303
- DOI: 10.1093/abm/kaac056
Leveraging Ecological Momentary Assessment to Examine Bi-directional Associations Between Sleep Quality, Adolescent/Young Adult Alcohol Craving and Use
Abstract
Background: Alcohol use is common among adolescents and young adults (AYA) and linked to poor sleep quality. Poor sleep quality may also increase alcohol use and alcohol craving, yet bi-directional relations between sleep quality and AYA alcohol use are poorly understood.
Purpose: This study examined bi-directional associations between sleep quality, alcohol craving, and alcohol use in AYA using ecological momentary assessment (EMA) and explored if biological sex, age, or race moderated these associations.
Methods: This pre-registered secondary analysis pooled EMA data from the baseline, pre-randomization period (M = 8.18 days, range = 1-17) in two double-blind randomized placebo-controlled clinical trials examining medication effects on alcohol use in AYA (N = 115). Each morning, participants reported sleep quality and alcohol consumption (i.e., number of standard drinks) from the previous day, and craving was rated at several random points each day.
Results: Multilevel modeling showed that poorer average sleep quality was associated with higher levels of alcohol craving for females but not for males, and better overall levels of sleep quality were associated with decreased likelihood of engaging in alcohol use. No other person- or day-level associations between sleep and alcohol use emerged.
Conclusions: Better sleep quality may be protective against alcohol use in AYA, and female AYA who report poorer sleep quality may experience higher levels of alcohol craving. Research and clinical assessment of AYA sleep quality can contribute to understanding of factors promoting alcohol craving and use.
Keywords: Adolescents and young adults; cological momentary assessment; lcohol use; leep behaviors; raving.
Plain language summary
This study explored how alcohol use among adolescents and young adults influences sleep quality as well as how sleep quality influences alcohol use and alcohol craving. Each morning, for approximately 1 week, participants reported their alcohol use from the prior day and their sleep quality from the prior night. They also rated their alcohol craving several times each day. Results showed that better overall sleep quality was associated with a lower likelihood of alcohol use. Poorer average sleep quality was associated with higher alcohol craving for females but not males. These findings suggest that better sleep quality may protect against alcohol use among youth and serve as a protective factor against alcohol craving for females.
© Society of Behavioral Medicine 2023. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.
Figures
Similar articles
-
How adolescents' working memory abilities relate to their alcohol craving in real-life contexts depends on biological sex.Drug Alcohol Depend. 2021 Apr 1;221:108642. doi: 10.1016/j.drugalcdep.2021.108642. Epub 2021 Feb 21. Drug Alcohol Depend. 2021. PMID: 33647588 Free PMC article. Clinical Trial.
-
Momentary associations between stress and alcohol craving in the naturalistic environment: differential associations for Black and White young adults.Addiction. 2022 May;117(5):1284-1294. doi: 10.1111/add.15740. Epub 2021 Dec 3. Addiction. 2022. PMID: 34859912 Free PMC article.
-
Risk-Taking Propensity, Affect, and Alcohol Craving in Adolescents' Daily Lives.Subst Use Misuse. 2019;54(13):2218-2228. doi: 10.1080/10826084.2019.1639753. Epub 2019 Jul 15. Subst Use Misuse. 2019. PMID: 31305203 Free PMC article.
-
Sleep-Related Predictors of Risk for Alcohol Use and Related Problems in Adolescents and Young Adults.Alcohol Res. 2024 Mar 14;44(1):02. doi: 10.35946/arcr.v44.1.02. eCollection 2024. Alcohol Res. 2024. PMID: 38500552 Free PMC article. Review.
-
Ecological momentary assessment studies of comorbid PTSD and alcohol use: A narrative review.Addict Behav Rep. 2019 Jul 17;10:100205. doi: 10.1016/j.abrep.2019.100205. eCollection 2019 Dec. Addict Behav Rep. 2019. PMID: 31528685 Free PMC article. Review.
Cited by
-
Daily associations between sleep and alcohol use among veterans: Acute and cumulative effects.Addiction. 2025 May;120(5):895-904. doi: 10.1111/add.16770. Epub 2025 Jan 18. Addiction. 2025. PMID: 39825712
-
Does sleep relate to next-day cannabis use during treatment? Findings from an adolescent and young adult motivational enhancement and cognitive behavioral therapy plus topiramate intervention.Drug Alcohol Depend. 2023 Dec 1;253:111006. doi: 10.1016/j.drugalcdep.2023.111006. Epub 2023 Oct 23. Drug Alcohol Depend. 2023. PMID: 37944198 Free PMC article.
-
A test of competing mediators linking trouble sleeping to cannabis use in adolescents and emerging adults.Exp Clin Psychopharmacol. 2024 Jun;32(3):316-328. doi: 10.1037/pha0000693. Epub 2023 Dec 21. Exp Clin Psychopharmacol. 2024. PMID: 38127518 Free PMC article.
-
Short-term prospective and reciprocal relations between social anxiety symptoms and sleep quality among community-recruited adolescents.Psychol Health. 2025 Apr 12:1-18. doi: 10.1080/08870446.2025.2491586. Online ahead of print. Psychol Health. 2025. PMID: 40219786
References
-
- Substance Abuse and Mental Health Services Administration (2019). Mental Health Services Administration. Key substance use and mental health indicators in the United States: Results from the 2018 National Survey on Drug Use and Health (HHS Publication No. PEP19-5068, NSDUH Series H-54). Rockville, MD: Center for Behavioral Health Statistics and Quality.
-
- Marshall EJ. Adolescent alcohol use: risks and consequences. Alcohol Alcohol. 2014; 49(2): 160–164. - PubMed
-
- Dregan A, Armstrong D.. Adolescence sleep disturbances as predictors of adulthood sleep disturbances—a cohort study. J Adolesc Health. 2010; 46(5): 482–487. - PubMed
Publication types
MeSH terms
Substances
Grants and funding
LinkOut - more resources
Full Text Sources
Medical
Research Materials