Alcohol and sleep problems in primary care patients: a report from the AAFP National Research Network.
OBJECTIVE
Hazardous and harmful drinking and sleep problems are common, but their associations among patients seen in primary care have not been examined. We hypothesized that greater levels of alcohol consumption would be associated with several self-reported sleep problems.


METHODS
In a cross-sectional survey in primary care practices, 94 participating clinicians recruited up to 30 consecutive adult patients, and both clinicians and patients completed anonymous postvisit questionnaires. Patients were asked questions on demographics, alcohol consumption, cardinal symptoms of alcohol use disorders, sleep quality, insomnia, sleep apnea, and symptoms of restless leg syndrome. Multivariate analyses explored the associations of drinking status (none, moderate, or hazardous) and sleep problems, adjusting for demographics and clustering of patients within physician.


RESULTS
Of 1,984 patients who responded, 1,699 (85.6%) provided complete data for analysis. Respondents' mean age was 50.4 years (SD 17.4 years), 67% were women, and 72.9% were white. Of these, 22.3% reported hazardous drinking, 47.8% reported fair or poor overall sleep quality, and 7.3% reported a diagnosis or treatment of sleep apnea. Multivariate analyses showed no associations between drinking status and any measure of insomnia, overall sleep quality, or restless legs syndrome symptoms. Moderate drinking was associated with lower adjusted odds of sleep apnea compared with nondrinkers (OR = 0.61; 95% CI, 0.38-1.00). Using alcohol for sleep was strongly associated with hazardous drinking (OR = 4.58; 95% CI, 2.97-7.08, compared with moderate drinking).


CONCLUSIONS
Moderate and hazardous drinking were associated with few sleep problems. Using alcohol for sleep, however, was strongly associated with hazardous drinking relative to moderate drinking and may serve as a prompt for physicians to ask about excessive alcohol use.
Department of Family and Community Medicine, University of Missouri, Columbia, MO 65212, USA. VinsonD@health.missouri.edu
Daniel C
DC
Vinson
Brian K
BK
Manning
James M
JM
Galliher
L Miriam
LM
Dickinson
Wilson D
WD
Pace
Barbara J
BJ
Turner
D000428:Alcohol Drinking / Q000009:adverse effects*; D000437:Alcoholism / Q000150:complications; D000704:Analysis of Variance; D016001:Confidence Intervals; D003430:Cross-Sectional Studies; D005260:Female; D006305:Health Status Indicators; D006306:Health Surveys; D006801:Humans; D016014:Linear Models; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D011320:Primary Health Care; D012307:Risk Factors; D057566:Self Report; D020919:Sleep Disorders, Intrinsic / Q000175:diagnosis* / Q000209:etiology; D012955:Societies, Medical; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires; D014481:United States