Prevalence and correlates of withdrawal-related insomnia among adults with alcohol dependence: results from a national survey.
Insomnia during acute alcohol withdrawal (AWD) as well as persisting insomnia during postacute withdrawal is associated with relapse. Rates of insomnia in clinical samples of alcohol-dependent patients range from 36% to 91%, but the prevalence of AWD-related insomnia in the general population is unknown. The purpose of this study was to describe the prevalence of insomnia as a symptom of acute AWD and its correlates in a general population of alcohol-dependent individuals. Data were analyzed from the 2001 to 2002 National Epidemiologic Survey on Alcohol and Related Conditions, which sampled 43,093 adults. The prevalence of AWD-related insomnia among individuals with a lifetime diagnosis of alcohol dependence was 31.7%, which ranked fourth among the eight listed DSM-IV withdrawal symptoms. Among individuals who met lifetime criteria for both alcohol dependence and AWD, the prevalence of insomnia was approximately 50%. Lifetime diagnoses of major depression and drug use disorders were significant correlates of AWD-related insomnia in multivariate analyses. A less than 1-year duration of the heaviest drinking period as well as the onset of alcohol dependence between ages 18 and 27 were negatively associated with AWD-related insomnia. AWD-related insomnia is a common symptom among alcohol-dependent adults in the general population and is related to lifetime co-occurring diagnoses, age at onset of alcohol dependence, and duration of heaviest drinking period. Its prevalence in the general population provides a representative base rate against which to compare the widely varying rates reported in clinical populations. Because of its relatively frequent prevalence and association with relapse, assessment and treatment of AWD-related insomnia should be routinely considered in clinical settings.
Department of Psychiatry, University of Michigan Medical School, Ann Arbor, Michigan, USA. kbrower@umich.edu
Kirk J
KJ
Brower
Brian E
BE
Perron
D000293:Adolescent; D000328:Adult; D000437:Alcoholism / Q000150:complications / Q000523:psychology*; D000431:Ethanol / Q000009:adverse effects*; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D007319:Sleep Initiation and Maintenance Disorders / Q000150:complications* / Q000453:epidemiology*; D013375:Substance Withdrawal Syndrome / Q000150:complications*; D014481:United States / Q000453:epidemiology
D000431:Ethanol