Department of Psychiatry, University of Missouri, Columbia, MO.
Sleep. 2021 Feb 12;44(2). doi: 10.1093/sleep/zsaa171.
More than half of young adults at risk for alcohol-related harm report symptoms of insomnia. Insomnia symptoms, in turn, have been associated with alcohol-related problems. Yet one of the first-line treatments for insomnia (Cognitive Behavioral Therapy for Insomnia or CBT-I) has not been tested among individuals who are actively drinking. This study tested (1) the feasibility and short-term efficacy of CBT-I among binge-drinking young adults with insomnia and (2) improvement in insomnia as a predictor of improvement in alcohol use outcomes.
Young adults (ages 18-30 years, 75% female, 73% college students) who met criteria for Insomnia Disorder and reported 1+ binge drinking episode (4/5+ drinks for women/men) in the past month were randomly assigned to 5 weekly sessions of CBT-I (n = 28) or single-session sleep hygiene (SH, n = 28). All participants wore wrist actigraphy and completed daily sleep surveys for 7+ days at baseline, posttreatment, and 1-month follow-up.
Of those randomized, 43 (77%) completed posttreatment (19 CBT-I, 24 SH) and 48 (86%) completed 1-month follow-up (23 CBT-I, 25 SH). CBT-I participants reported greater posttreatment decreases in insomnia severity than those in SH (56% vs. 32% reduction in symptoms). CBT-I did not have a direct effect on alcohol use outcomes; however, mediation models indicated that CBT-I influenced change in alcohol-related consequences indirectly through its influence on posttreatment insomnia severity.
CBT-I is a viable intervention among individuals who are actively drinking. Research examining improvement in insomnia as a mechanism for improvement in alcohol-related consequences is warranted.
U.S. National Library of Medicine, https://clinicaltrials.gov/ct2/show/NCT03627832, registration #NCT03627832.
超过一半有酒精相关危害风险的年轻人报告有失眠症状。反过来，失眠症状与酒精相关问题有关。然而，失眠的一线治疗方法之一（失眠认知行为疗法或 CBT-I）尚未在正在饮酒的人群中进行测试。本研究测试了（1）失眠的狂欢饮酒的年轻人中 CBT-I 的可行性和短期疗效，以及（2）失眠的改善是否可预测酒精使用结果的改善。
符合失眠障碍标准且在过去一个月内报告有 1 次以上狂欢饮酒（女性 4/5 次以上/男性）的年轻人（年龄 18-30 岁，75%为女性，73%为大学生）被随机分配到 5 次每周的 CBT-I 治疗（n = 28）或单次睡眠卫生（SH，n = 28）。所有参与者在基线、治疗后和 1 个月随访时佩戴腕部活动记录仪并完成 7 天以上的每日睡眠调查。
在随机分组的人群中，有 43 人（77%）完成了治疗后评估（19 名 CBT-I 组，24 名 SH 组），有 48 人（86%）完成了 1 个月随访（23 名 CBT-I 组，25 名 SH 组）。与 SH 组相比，CBT-I 组治疗后失眠严重程度的下降更大（症状减少 56%对 32%）。CBT-I 对酒精使用结果没有直接影响；然而，中介模型表明，CBT-I 通过对治疗后失眠严重程度的影响，间接地影响酒精相关后果的变化。
CBT-I 是一种可行的狂欢饮酒者干预措施。需要研究改善失眠作为改善酒精相关后果的机制。
美国国立卫生研究院，https://clinicaltrials.gov/ct2/show/NCT03627832，注册号 NCT03627832。
