769 Is Alcohol Craving associated with Insomnia in Patients with Comorbid Insomnia and Alcohol Use Disorder?

• Published in: Sleep (New York, N.Y.) Vol. 44; no. Supplement_2; pp. A299 - A300
• Main Authors: Krouse, Ryan, Aguiar, Taylor, Mazur, Rena, Makar, Karen, Kampman, Kyle, Rivera, Louis
• Format: Journal Article
• Language: English
• Published: Westchester Oxford University Press 03.05.2021
• Subjects: Alcohol use; Comorbidity; Insomnia
• ISSN: 0161-8105; 1550-9109
• DOI: 10.1093/sleep/zsab072.766

Introduction A preliminary study showed the existence of a relationship between alcohol craving and insomnia symptoms. The current investigation aimed to further assess the relationship between obsessive and compulsive qualities of alcohol craving and insomnia disorder in a larger sample of subjects with Alcohol Use Disorder (AUD) seeking treatment for their drinking. Methods We used baseline cross-sectional data from a clinical trial of treatment-seeking patients with AUD (N=123). We used the following instruments: Insomnia Severity Index (ISI) total score for insomnia; Obsessive Compulsive Drinking Scale (OCDS) scale scores for alcohol craving; Time-Line follow Back interview for computing the number of drinks per drinking day within the past 90 days; Hamilton Anxiety Rating Scale total score for the anxiety symptoms; and Addiction Severity Index for demographic variables. We used bivariate analysis to evaluate whether alcohol craving outcome measures (OCDS subscale scores and total score) were independently associated with the ISI total score. A multivariable model adjusted for sociodemographic and clinical covariates further evaluated this relationship between OCDS and ISI total scores. Results The mean (SD) age was 44.02 (10.37) years with 13.29 (3.10) years of education, 83.74% were males, 41.80% identified themselves as White, 17.21% were married, and 56.09% were employed. In a bivariate analysis, ISI total score was associated with the obsessive subscale (β=0.25, p<0.0001), compulsive drinking subscale (β=0.24, p<0.002), and OCDS total score (β=0.50, p<0.0001). The OCDS total score showed a stronger association with the insomnia symptoms (ISI items 1a-1c) (β=0.99, p<0.0001) than the manifestations of insomnia symptoms (items 2–5; β=0.83, p<0.0001). In the multivariable model adjusted for covariates, the relationship between OCDS and ISI total scores continued to remain significant (β=0.37, R2=0.18, p=0.01). Conclusion This study not only confirmed that alcohol craving was associated with insomnia in a larger sample but also demonstrated that insomnia is linked to both obsessive thoughts about alcohol use and compulsive drinking behavior, especially its obsessive aspect. These findings add to the growing literature on the relationship between a pathologic drive for alcohol use and abnormal wakefulness. Support (if any) The study was supported by VA grant IK2CX000855 (S.C.) and NIH grants R01 AA016553 (K.M.K.).