This work was supported by a grant from the National Institute on Alcohol Abuse and Alcoholism (AA14351). Data gathering for the Baltimore Epidemiologic Catchment Area (ECA) Follow-up survey was supported by a grant from the National Institute of Mental Health (MH47447). Data gathering for the original surveys was supported by the ECA Program of the National Institute of Mental Health Division of Biometry and Epidemiology. The principal investigators, co-investigators, and grant award numbers during data gathering were Jerome K. Myers, Myrna M. Weissman, and Gary L. Tischler at Yale University (MH34224); Morton Kramer, Ernest Gruenberg, and Sam Shapiro at The Johns Hopkins University (MH33870); Lee N. Robins and John E. Helzer at Washington University (MH33883); Dan Blazer and Linda George at Duke University (MH35386); and Marvin Karno, Richard L. Hough, Javier I. Escobar, M. Audrey Burnam, and Dianne Timbers at the University of California, Los Angeles (MH35865). At the National Institute of Mental Health, principal collaborators during data gathering were Darrel A. Regier, Ben Z. Locke, William W. Eaton, and Jack D. Burke, Jr.
Association of Sleep Disturbance with Chronicity and Remission of Alcohol Dependence: Data from a Population-Based Prospective Study
Article first published online: 3 MAY 2006
Alcoholism: Clinical and Experimental Research
Volume 28, Issue 10, pages 1533–1540, October 2004
How to Cite
Crum, R. M., Ford, D. E., Storr, C. L. and Chan, Y.-F. (2004), Association of Sleep Disturbance with Chronicity and Remission of Alcohol Dependence: Data from a Population-Based Prospective Study. Alcoholism: Clinical and Experimental Research, 28: 1533–1540. doi: 10.1097/01.ALC.0000141915.56236.40
- Issue published online: 3 MAY 2006
- Article first published online: 3 MAY 2006
- Received for publication January 19, 2004; accepted July 19, 2004.
- Alcohol Dependence;
Objective: We assessed the association of three types of self-reported sleep disturbances (insomnia, hypersomnia, and sleep disturbance caused by worry) among individuals with chronic and remitted alcohol dependence, using prospectively gathered data from a population-based sample.
Methods: Probability samples of area residents were selected by census tracks and households in Baltimore, MD, in 1981, as part of the Epidemiologic Catchment Area program (n= 3481). Between 1993 and 1996, the original cohort was traced, and 73% of the survivors were re-interviewed (n= 1920). Three groups for alcohol dependence status were identified: (1) chronic, (2) remitted, and (3) no lifetime or current history of dependence. Logistic regression models were used to assess the association between alcohol dependence status for each type of sleep disturbance.
Results: Of the 248 individuals with alcohol dependence, most had achieved remission of dependence by the time of the median 13-year follow-up interview (n= 211). A total of 37 met criteria for chronic dependence. After holding constant potential confounders (age, sex, race, educational level, marital status, psychiatric and illicit drug disorder history, health services use, and age of onset of first alcohol-related problem), we found that chronic dependence was associated with insomnia (odds ratio = 2.60; 95% confidence interval = 1.11–6.08; p= 0.03), relative to those without a history of dependence. Remitted dependence was not associated with sleep disturbance in the models adjusted for covariates. In supplemental analyses, we assessed the association of drinking status with alcohol dependence remission.
Conclusions: Individuals with persistent alcohol dependence have greater odds of insomnia than those whose alcohol dependence remits. The need for prospectively gathered data from community-based samples to assess further the temporal relationships of sleep disturbance, alcohol dependence, and alcohol consumption level is discussed.