Comprehensive assessment of insomnia in recovering alcoholics using daaily sleep diaries and ambulatory monitoring

Background: Many alcoholics continue to experience disrupted sleep after quitting drinking. Previous studies with recovering alcoholics have relied on retrospective questionnaires and a single night of polysomnography to document sleep problems. In the present study, sleep was assessed at home over the course of a week using both subjective and objective sleep measures. Methods: A mixed gender group of alcoholics in recovery (n = 63) experiencing insomnia underwent a multimodal sleep assessment including a structured interview, daily sleep diaries, questionnaires, and ambulatory, sleep monitoring. Alcoholics with short-term (<12 months) and long-term (>12 months) abstinence had their sleep monitored prospectively and were compared. Results: Over half of the participants reported sleep problems that predated the onset of alcohol dependence. Alcoholics with short- and long-term abstinence had similarly disturbed sleep. Overall, problems with getting to sleep were worse than sleep maintenance difficulties. Severity of insomnia was unrelated to drinking history and modestly correlated with the current level of depressive symptoms. Poor sleep hygiene was evident in the sample. Conclusions: Alcoholics can experience sleep problems for many months after quitting drinking. Implications for sleep interventions with this population are discussed.