title: Critical Transitions: A Mixed Methods Examination of Sleep from Inpatient Alcohol Rehabilitation Treatment to the Community.
abstract: OBJECTIVE
  This prospective, repeated measures study utilized a convergent parallel mixed methods approach to assess sleep experiences among individuals who were alcohol-dependent undergoing inpatient detoxification and treatment at a clinical research facility across the transition periods associated with the rehabilitation process: the initial adjustment to becoming an inpatient and the transition from inpatient to outpatient status.
  
  
  METHODS
  This study included individual semi-structured interviews and quantitative measures relating to psychological distress, sleep quality, daytime sleepiness, and sleep-related beliefs and behavior (n = 33; 66.7% male). Interviews were conducted and questionnaires were administered within one week of participants' scheduled discharge date and again four to six weeks post-discharge when they returned for a follow-up visit (or via phone).
  
  
  RESULTS
  Participants self-reported significant sleep disturbances at both study time points. Of those participants with valid data at both time points (n = 28), there were no significant changes in mean scores from pre- to post-discharge with the exception of self-efficacy for sleep (SE-S) being significantly higher post-discharge. Preliminary qualitative findings suggested differences between those with ongoing sleep disturbances, those whose sleep disturbances had resolved, and those with no sleep disturbances at either time point.
  
  
  CONCLUSIONS
  This analysis highlights individual variation in sleep throughout the process of inpatient treatment and transition to outpatient aftercare in individuals with alcohol dependence. Collecting quantitative and qualitative data concurrently and combining emerging themes from qualitative data with quantitative analyses allowed for a more thorough examination of this relatively novel area of research and provided information that can be utilized to inform future behavioral sleep interventions.
authors: National Institutes of Health Clinical Center, Bethesda, Maryland, United States of America.|National Institute on Alcohol Abuse and Alcoholism, Bethesda, Maryland, United States of America.
authors: Alyssa Todaro
authors: AT
authors: Brooks
authors: National Institutes of Health Clinical Center, Bethesda, Maryland, United States of America.
authors: Michael
authors: M
authors: Krumlauf
authors: University of Maryland School of Public Health, Department of Behavioral and Community Health, College Park, Maryland, United States of America.
authors: Craig S
authors: CS
authors: Fryer
authors: University of Maryland School of Public Health, Department of Behavioral and Community Health, College Park, Maryland, United States of America.
authors: Kenneth H
authors: KH
authors: Beck
authors: National Institutes of Health Clinical Center, Bethesda, Maryland, United States of America.
authors: Li
authors: L
authors: Yang
authors: National Institute on Alcohol Abuse and Alcoholism, Bethesda, Maryland, United States of America.
authors: Vijay A
authors: VA
authors: Ramchandani
authors: National Institutes of Health Clinical Center, Bethesda, Maryland, United States of America.
authors: Gwenyth R
authors: GR
authors: Wallen
mesh_terms: D000328:Adult; D000437:Alcoholism / Q000503:physiopathology; D005260:Female; D006801:Humans; D007297:Inpatients / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012890:Sleep / Q000502:physiology*; D012894:Sleep Stages / Q000502:physiology; D012893:Sleep Wake Disorders / Q000503:physiopathology; D011795:Surveys and Questionnaires