title: The course of sleep disturbances in early alcohol recovery: an observational cohort study.
abstract: BACKGROUND
  Understanding the course and determinants of sleep disturbances in alcoholic patients may help identify patients at high risk of persistent sleep problems, relapse and guide treatment interventions.
  
  
  METHODS
  We prospectively administered the Pittsburgh Sleep Quality Index (PSQI) to all patients (N = 196) admitted to a 1-month residential treatment program. Our analysis excluded patients with active drug abuse/dependence. Demographic data, psychiatric diagnoses, Patient Health Questionnaire-9 (PHQ-9), Alcohol Use Disorders Identification Test (AUDIT) and Inventory of Drug Taking Situations (IDTS) scores were obtained. Univariate and logistic regression analyses were performed using sex, age, hazardous alcohol use, PHQ-9 scores, hypnotic use, and use of alcohol as a hypnotic as correlates to admission PSQI scores and improvement in PSQI scores.
  
  
  RESULTS
  A total of 119 alcoholic patients met inclusion criteria (mean age 50.6 ± 13.2 years). The rates of sleep disturbances at admission and discharge were 69.3% and 49.1%, respectively. Self report of using alcohol to fall asleep and use of hypnotics were associated with elevated PSQI scores. Total PSQI scores improved over 4 weeks (p < .001). Change in PSQI scores was not effected by gender, use of hypnotics, hazardous alcohol use, use of alcohol as a hypnotic or co-morbid psychiatric diagnosis. Older age predicted improvement in PSQI scores in patients with sleep disturbances (p = .004).
  
  
  CONCLUSIONS
  While a large proportion of alcoholics had sleep disturbances upon admission and at discharge from a residential treatment program, only older age was associated with improvements in sleep disturbances during early alcohol recovery.
authors: Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota; Center for Sleep Medicine, Mayo Clinic, Rochester, Minnesota.
authors: Bhanu Prakash
authors: BP
authors: Kolla
authors: Terry
authors: T
authors: Schneekloth
authors: Joanna
authors: J
authors: Biernacka
authors: Meghna
authors: M
authors: Mansukhani
authors: Jennifer
authors: J
authors: Geske
authors: Victor
authors: V
authors: Karpyak
authors: Daniel
authors: D
authors: Hall-Flavin
authors: Larissa
authors: L
authors: Louikianova
authors: Mark A
authors: MA
authors: Frye
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000437:Alcoholism / Q000150:complications* / Q000628:therapy*; D015331:Cohort Studies; D017831:Diagnosis, Dual (Psychiatry); D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011569:Psychiatric Status Rating Scales; D012114:Residential Treatment; D007319:Sleep Initiation and Maintenance Disorders / Q000150:complications* / Q000503:physiopathology*; D016896:Treatment Outcome; D055815:Young Adult