University of Michigan Addiction Research Center, Ann Arbor, USA.
Alcohol Clin Exp Res. 2012 Sep;36(9):1600-7. doi: 10.1111/j.1530-0277.2012.01771.x. Epub 2012 Apr 4.
Insomnia is an important symptom in alcohol-dependent patients because it may persist despite abstinence and predispose to relapse to drinking. The goal of the present study was to evaluate the prevalence and clinical correlates of insomnia in a sample of 302 alcohol-dependent patients admitted to treatment programs in Poland.
Participants were mostly men (73.8%) with a mean (SD) age of 43.5 (9.7) years. Insomnia in the past 1 month was assessed using a total score of 6 or higher on the Athens Insomnia Scale.
Insomnia affected 62.9% of patients, and delayed sleep induction was the most common subtype. Insomnia was associated in bivariate analyses with less education, inadequate finances, problem drinking at an earlier age of onset, drinking frequency and quantity, drinking-related consequences, severity of alcohol and nicotine dependence, psychiatric and physical severity, and a childhood history of sexual or physical abuse (p < 0.05). Logistic regression analysis showed that mental and physical health status, severity of alcohol dependence, number of drinking days in the past 3 months, and childhood abuse were independent predictors of insomnia, explaining approximately 30 to 40% of the variance.
More than 60% of alcohol-dependent patients in a Polish sample screened positive for insomnia using a validated scale, a rate similar to those assessed with other scales in other countries. The study also showed that insomnia in alcohol-dependent patients is associated with poor physical health and childhood abuse, similar to the general population. The multifactorial nature of insomnia in alcohol-dependent patients has treatment implications.
失眠是酒精依赖患者的一个重要症状，因为即使在戒酒后，它仍可能持续存在，并导致复发饮酒。本研究的目的是评估 302 名在波兰治疗项目中接受治疗的酒精依赖患者样本中失眠的患病率和临床相关性。
参与者主要为男性（73.8%），平均年龄（标准差）为 43.5（9.7）岁。过去 1 个月的失眠情况使用雅典失眠量表总分 6 分或以上进行评估。
失眠影响了 62.9%的患者，其中最常见的亚型是睡眠潜伏期延长。在单变量分析中，失眠与受教育程度较低、经济状况不佳、更早开始出现问题饮酒、饮酒频率和数量、与饮酒相关的后果、酒精和尼古丁依赖的严重程度、精神和身体健康状况、以及童年时期性或身体虐待史有关（p < 0.05）。逻辑回归分析显示，心理健康和身体健康状况、酒精依赖严重程度、过去 3 个月的饮酒天数以及童年期受虐是失眠的独立预测因素，可解释约 30%至 40%的方差。
使用经过验证的量表对波兰样本中的 60%以上的酒精依赖患者进行筛查，发现他们存在失眠，这一比例与其他国家使用其他量表评估的比例相似。该研究还表明，酒精依赖患者的失眠与身体健康状况不佳和童年期受虐有关，这与一般人群相似。酒精依赖患者失眠的多因素性质对治疗有影响。
