Hasler Brant P, Kirisci Levent, Clark Duncan B
Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.
J Stud Alcohol Drugs. 2016 Jul;77(4):649-55. doi: 10.15288/jsad.2016.77.649.
Limited prospective data indicate that premorbid sleep disturbances elevate the risk for subsequent alcohol and other drug problems, yet the implications for subsequent substance involvement trajectories remain unclear. In the present analyses, we examined risk associations between sleep characteristics during late childhood and the onset of substance use and substance use disorders into adulthood.
A sample of 707 children was recruited at ages 9-13 years and followed over seven additional visits through age 30 years. In 304 participants, fathers had a history of substance use disorder involving illicit drugs. Self-reported baseline sleep characteristics (restless sleep and variable sleep timing) were assessed at approximately ages 9-13 years. Assessment of alcohol, cannabis, and cocaine involvement occurred at follow-up visits. Cox proportional hazard models tested sleep characteristics as predictors of two substance-related outcomes (age at first use or diagnosis of disorder), as well as the onset of major depressive disorder.
Restless sleep at baseline significantly predicted an earlier onset age for trying alcohol and cannabis and showed a trend toward predicting early onset of cannabis use disorder. Restless sleep also predicted an earlier onset of depression. Irregular sleep timing at baseline significantly predicted an earlier onset age for alcohol use disorder and showed trends toward predicting early onsets of disorders of cannabis and cocaine use.
Disturbed sleep during late childhood appears to accelerate the onset of not only initial substance use but also the development of clinically defined substance use disorder. Sleep-focused preventative efforts during late childhood may reduce the incidence of mood and substance use disorders.
有限的前瞻性数据表明，病前睡眠障碍会增加后续出现酒精及其他药物问题的风险，但对后续物质使用轨迹的影响仍不明确。在本分析中，我们研究了儿童晚期的睡眠特征与成年后物质使用及物质使用障碍发病之间的风险关联。
招募了707名9至13岁的儿童作为样本，并在30岁之前进行了另外七次随访。在304名参与者中，父亲有涉及非法药物的物质使用障碍病史。在大约9至13岁时评估自我报告的基线睡眠特征（睡眠不安和睡眠时间多变）。在随访时评估酒精、大麻和可卡因的使用情况。Cox比例风险模型测试了睡眠特征作为两种与物质相关结果（首次使用或诊断障碍的年龄）以及重度抑郁症发病的预测因素。
基线时睡眠不安显著预测了尝试酒精和大麻的更早发病年龄，并显示出预测大麻使用障碍早期发病的趋势。睡眠不安还预测了抑郁症的更早发病。基线时睡眠时间不规律显著预测了酒精使用障碍的更早发病年龄，并显示出预测大麻和可卡因使用障碍早期发病的趋势。
儿童晚期睡眠障碍似乎不仅会加速初次物质使用的发病，还会加速临床定义的物质使用障碍的发展。儿童晚期以睡眠为重点的预防措施可能会降低情绪和物质使用障碍的发生率。
