Center for Developmental Science, The University of North Carolina, Chapel Hill, United States.
Center for Developmental Science, The University of North Carolina, Chapel Hill, United States; Department of Health Behavior, The University of North Carolina at Chapel Hill, United States.
Addict Behav. 2018 Aug;83:95-101. doi: 10.1016/j.addbeh.2017.11.001. Epub 2017 Nov 12.
The causal direction of the relationship between sleep disturbance and drug cravings is unknown. Based on resource depletion literature, we hypothesized that sleep difficulties lead to cravings. We tested whether sleep quality predicts craving at the within- or between-person level, with perceived willpower as a multilevel mediator.
We used ecological momentary assessments (EMA) to compare two models of temporal precedence. Participants in addiction treatment (N=122) were sent four surveys each day for three weeks. Participants rated previous night's sleep quality and level of cravings and willpower.
The between- (β=-0.18, SE=0.06) and within-person (β=-0.02, SE=0.02) effects of maximum daily craving on sleep quality were significant, as were the between- (β=-0.33, SE=0.08) and within-person (β=-0.08; SE=0.03) effects of daily sleep quality on maximum daily cravings. In the mediation analysis of the indirect effect of sleep quality on cravings via willpower, both the indirect effect for the between-person pathway (β=-0.27, SE=0.07) and the indirect within-person pathway (β=-0.01, SE=0.01) were significant.
EMA methodology allowed for disentanglement of the temporal relationship between sleep and cravings. We found support for the resource depletion hypothesis, operationalized by linking sleep quality to cravings via willpower. However, the magnitude of the association between sleep quality and cravings was stronger at the between-person level, suggesting a potentially cumulative effect of poor sleep on cravings. These results suggest that clinicians should ask patients about chronic sleep problems, as these may pose a risk for relapse.
睡眠障碍与药物渴求之间的关系的因果方向尚不清楚。基于资源耗竭文献，我们假设睡眠困难导致了渴求。我们测试了睡眠质量是否可以预测个体内或个体间的渴求，将感知意志力作为一个多层次的中介。
我们使用生态瞬时评估（EMA）来比较时间优先顺序的两种模型。接受成瘾治疗的参与者（N=122）在三周内每天收到四次调查。参与者评估前一天晚上的睡眠质量和渴望程度以及意志力。
最大日渴望对睡眠质量的个体间（β=-0.18，SE=0.06）和个体内（β=-0.02，SE=0.02）效应以及最大日渴望对每日睡眠质量的个体间（β=-0.33，SE=0.08）和个体内（β=-0.08；SE=0.03）效应均有统计学意义。在通过意志力对渴望的睡眠质量间接效应的中介分析中，个体间路径（β=-0.27，SE=0.07）和个体内路径（β=-0.01，SE=0.01）的间接效应均有统计学意义。
EMA 方法允许理清睡眠和渴望之间的时间关系。我们支持资源耗竭假说，通过将睡眠质量与意志力联系起来来验证这一假说，从而验证了这一假说。然而，睡眠质量和渴望之间的关联在个体间水平上的强度更大，这表明睡眠质量差对渴望可能存在累积效应。这些结果表明，临床医生应该询问患者是否存在慢性睡眠问题，因为这可能增加复发的风险。
