Impaired sleep in alcohol misusers and dependent alcoholics and the impact upon outcome

Background: There is very little work that has investigated the self-reported sleep status of alcohol misusers. This study addressed that imbalance. Methods: The study consisted of two parts: 1) the outpatient study, a sample of DSM-IV alcohol-dependent subjects who were referred to an outpatient clinic and were given a series of questionnaires, including the Pittsburgh Sleep Quality Index (PSQI); and 2) the inpatient study, a group of DSM-IV alcohol-dependent subjects whose sleep was assessed by the Nottingham Health Profile (NHP) sleep subscore at the start of the study and again at the 12-week follow-up. Both the PSQI and NHP are self-report indices whereby higher scores indicate a poor sleep quality. Results: In the outpatient study, the PSQI scores were significantly higher in the alcoholics (n = 31) compared with the controls (n = 49). There were no differences in the PSQI scores among mildly (n = 11), moderately (n = 10), and severely (n = 11) dependent drinkers. The PSQI total scores correlated with the Beck Depression Index but not with severity of dependence or alcohol problem scores. Sleep latency emerged as the most significant predictor of relapse, and sleeping badly was associated with poor outcome at the 12-week follow-up in the inpatient study. Conclusion: Self-reported sleep disturbance can provide clinicians with information to plan better treatment for alcohol misusers.