Daily associations between modifiable sleep behaviors and nighttime sleep among young adult drinkers with insomnia

Abstract

Study objectives: Empirical evidence linking individual sleep hygiene practices to subsequent sleep parameters is limited, particularly at the daily level. This study compared the strength of daily, within-person associations between these modifiable sleep behaviors and nighttime sleep in young adult drinkers with insomnia.

Methods: Young adults (ages 18-30 years; n = 56) who met diagnostic criteria for insomnia and reported past-month binge drinking wore wrist actigraphy and completed online sleep diaries for 8.5 days (standard deviation = 2.3; 477 reports). Diaries assessed engagement in 11 sleep hygiene recommendations. Multilevel models tested daily associations between sleep behaviors and 3 outcomes: sleep quality, self-reported sleep efficiency, and actigraphy-measured sleep efficiency.

Results: Participants self-reported better sleep quality/efficiency on days that they slept in a comfortable environment, limited naps to 30 minutes, and maintained a consistent wake time. They self-reported worse sleep quality and efficiency on nights that they avoided alcohol use before bedtime. No sleep behaviors were significantly associated with actigraphy-measured sleep efficiency after correcting for inflation in type I error.

Conclusions: The sleep hygiene recommendations most strongly associated with sleep at the daily level were consistent with stimulus control. Creating a comfortable sleep environment also emerged as an important correlate of daily sleep. Heavy drinkers with insomnia may perceive better sleep if they drink before bedtime; however, this finding may be unique to this population.

Citation: Miller MB, Curtis AF, Hall NA, et al. Daily associations between modifiable sleep behaviors and nighttime sleep among young adult drinkers with insomnia. J Clin Sleep Med. 2022;18(3):703-712.

Trial registration: ClinicalTrials.gov NCT03627832.

Keywords: alcohol; insomnia; sleep; sleep hygiene; stimulus control.

Conflict of interest statement

All authors have seen and approved the manuscript. This study was funded by the University of Missouri System Research Board Office (Principal Investigator Miller). Investigator contributions to this project were also supported by the National Institute on Alcohol Abuse and Alcoholism (K23AA026895, PI Miller; R21AA025175, PI Miller; T32AA013526, PI Sher), the National Institute of Nursing Research (R01NR017168, PI McCrae), and the U.S. Department of Defense (AR190047, PI McCrae). The National Institutes of Health and the U.S. Department of Defense had no role in study design; data collection, analysis, or interpretation; manuscript preparation; or the decision to submit the paper for publication. The parent trial was registered on ClinicalTrials.gov before data collection (ClinicalTrials.gov identifier: NCT03627832). The authors report no conflicts of interest.

© 2022 American Academy of Sleep Medicine.