Department of Psychiatry, University of Missouri School of Medicine, Columbia, MO, USA.
Department of Psychological Sciences, University of Missouri College of Arts and Sciences, Columbia, MO, USA.
Sleep. 2023 Dec 11;46(12). doi: 10.1093/sleep/zsad250.
Anecdotally, adults reach higher levels of subjective intoxication on days they are fatigued or sleep-deprived, but sleep is not typically discussed as a predictor of blood alcohol concentration (BAC) in clinical settings. To inform clinical work and future research, this perspective reviews data examining the impact of sleep (process S) and circadian (process C) factors on indicators of BAC in humans and animal models.
Literature searches of medical and psychological databases were conducted to identify articles that manipulated sleep/circadian factors and reported effects on indicators of alcohol pharmacology (e.g. BAC, alcohol metabolism).
Of the 86 full-text articles reviewed, 21 met inclusion criteria. Studies included manipulations of time of day, circadian phase (evidence for process C), and time in bed (evidence for process S). Evidence for time-of-day effects on alcohol pharmacology was most compelling. Studies also provided evidence for circadian phase effects, but failed to find support for time-in-bed effects. Although results were not uniform across studies, most evidence from human and animal models indicates that peak BACs occur toward the beginning of the biological day, with some studies indicating slower alcohol elimination rates at this time.
Circadian factors likely influence alcohol pharmacokinetics, perhaps due to altered elimination of alcohol from the body. This means that individuals may reach higher BACs if they drink during the morning (when, for most people, circadian alerting is low) versus other times of the day. Alcohol prevention and intervention efforts should highlight sleep/circadian health as a potential contributor to alcohol-related harm.
据传闻，成年人在疲劳或睡眠不足的日子里会达到更高水平的主观醉酒，但在临床环境中，睡眠通常不作为预测血液酒精浓度（BAC）的因素进行讨论。为了为临床工作和未来的研究提供信息，本观点综述了研究睡眠（过程 S）和昼夜节律（过程 C）因素对人类和动物模型中 BAC 指标影响的数据。
对医学和心理学数据库进行文献检索，以确定操纵睡眠/昼夜节律因素并报告对酒精药理学指标（例如 BAC、酒精代谢）影响的文章。
在审查的 86 篇全文文章中，有 21 篇符合纳入标准。这些研究包括对一天中的时间、昼夜节律相位（过程 C 的证据）和卧床时间（过程 S 的证据）的操纵。关于时间对酒精药理学影响的证据最有说服力。研究还提供了昼夜节律相位影响的证据，但未能发现支持卧床时间影响的证据。尽管研究结果并非在所有研究中都一致，但来自人类和动物模型的大多数证据表明，峰值 BAC 出现在生物日的开始，一些研究表明此时酒精消除率较慢。
昼夜节律因素可能会影响酒精药代动力学，这可能是由于身体对酒精的消除发生改变。这意味着，如果个体在早上（对于大多数人来说，昼夜节律警觉性较低）饮酒，而不是在一天中的其他时间饮酒，他们可能会达到更高的 BAC。酒精预防和干预措施应强调睡眠/昼夜节律健康是导致与酒精相关伤害的潜在因素。
