Hostname: page-component-586b7cd67f-2brh9 Total loading time: 0 Render date: 2024-11-27T07:58:12.976Z Has data issue: false hasContentIssue false

Sleep Related Beliefs and their Association with Alcohol Relapse Following Residential Alcohol Detoxification Treatment

Published online by Cambridge University Press:  28 June 2013

Neil Smith*
Affiliation:
Central and North West London NHS Foundation Trust, UK
Robert Hill
Affiliation:
South London and Maudsley NHS Foundation Trust, UK
Jane Marshall
Affiliation:
South London and Maudsley NHS Foundation Trust, UK
Francis Keaney
Affiliation:
South London and Maudsley NHS Foundation Trust, UK
Shamil Wanigaratne
Affiliation:
College of Medicine and Health Sciences, Abu Dhabi, United Arab Emirates
*
Reprint requests to Neil Smith, Clinical Psychologist, Addictions Directorate, Central and North West London NHS Foundation Trust, 4th Floor, Soho Centre for Health and Care, 1 Frith Street, London W1D 3HZ, UK. E-mail: [email protected]

Abstract

Background: Alcohol dependence is known to impact upon sleep, and poor sleep has been shown to affect relapse rates following treatment for alcohol dependence. Aims: The aim of this study was to investigate the association between sleep problems and relapse in dependent drinkers in an inpatient setting. This was done by studying sleep related cognitions in individuals undergoing medically assisted alcohol withdrawal. Method: Sleep and sleep-related cognitions data were collected for 71 individuals undergoing detoxification treatment. Sleep was measured using sleep diaries and actigraph motion monitors. Participants completed sleep-related cognition questionnaires and were subject to telephone follow-up interviews. The results were then used to predict relapse rates 4 weeks after discharge. Results: Longer sleep onset latency recorded on the unit predicted relapse at 4 weeks. Higher dysfunctional beliefs about sleep were found to be associated with lower relapse rates. Conclusions: This study suggests that some dysfunctional beliefs about sleep may support recovery following discharge from treatment. The study further supports the need for tailored cognitive-behavioural treatments for sleep difficulties in this population to reduce relapse rates.

Type
Research Article
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 2013 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Allen, R. P. and Wagman, A. M. (1975). Do sleep patterns relate to the desire for alcohol? Advances in Experimental Medicine and Biology, 59, 495508.CrossRefGoogle Scholar
Allen, R. P., Wagman, A. M. and Funderburk, F. R. (1977). Slow wave sleep changes: alcohol tolerance and treatment implications. Advances in Experimental Medicine and Biology, 85, 629640.Google Scholar
Arnedt, J. T., Conroy, D. A., Armitage, A. and Brower, K. J. (2011). Cognitive-behavioural therapy for insomnia in alcohol dependent patients: a randomized controlled pilot trial. Behaviour Research and Therapy, 49, 227233.Google Scholar
Arnedt, J. T., Conroy, D. A., Rutt, J., Aloia, M. S., Brower, K. J. and Armitage, R. (2007). An open-trial of cognitive-behavioural treatment for insomnia comorbid with alcohol dependence. Sleep Medicine, 8, 176180.CrossRefGoogle Scholar
Brower, K. J., Aldrich, M. S. and Hall, J. M. (1998). Polysomnographic and subjective sleep predictors of alcoholic relapse. Alcoholism: Clinical and Experimental Research, 22, 18641871.Google Scholar
Brower, K. J., Aldrich, M. S., Robinson, E. A. R., Zucker, R. A. and Greden, J. F. (2001). Insomnia, self-medication and relapse to alcoholism. American Journal of Psychiatry, 158, 399404.Google Scholar
Conroy, D. A., Arnedt, J. T., Brower, K. J., Strobbe, S., Consens, F., Hoffmann, R., et al. (2006). Perception of sleep in recovering alcohol-dependent patients with insomnia: relationship with future drinking. Alcoholism: Clinical and Experimental Research, 31, 19921999.Google Scholar
Crum, R. M., Storr, C. L., Chan, Y. and Ford, D. E. (2004). Sleep disturbance and risk for alcohol-related problems. American Journal of Psychiatry, 161, 11971203.Google Scholar
Currie, S. R., Clark, S., Hodgins, D. C. and el-Guebaly, N. (2004). Randomized controlled trial of brief cognitive-behavioural interventions for insomnia in recovering alcoholics. Addiction, 99, 11211132.Google Scholar
Currie, S. R., Wilson, K. G., Pontefract, A. J. and deLaplante, L. (2000). Cognitive-behavioral treatment of insomnia secondary to chronic pain. Journal of Consulting and Clinical Psychology, 68, 407416.CrossRefGoogle ScholarPubMed
Dreher, H. M. (2003). The effect of caffeine reduction on sleep quality and well being in person with HIV. Journal of Psychosomatic Research, 54, 191198.Google Scholar
Drummond, S. P. A., Gillin, C., Smith, T. L. and DeModena, A. (1998). The sleep of abstinent pure primary alcoholic patients: natural course and relationship to relapse. Alcoholism: Clinical and Experimental Research, 22, 17961802.Google Scholar
Edinger, J. D., Wohlgemuth, W. K., Radtke, R. A., Marsh, G. R. and Quillian, R. E. (2001). Does cognitive-behavioural insomnia therapy alter dysfunctional beliefs about sleep? Sleep, 24, 591599.Google Scholar
Espie, C. A. (2002). Insomnia: conceptual issues in the development, persistence and treatment of sleep disorder in adults. Annual Review of Psychology, 53, 215243.CrossRefGoogle ScholarPubMed
Espie, C. A., Brooks, D. N. and Lindsay, W. R. (1989). An evaluation of tailored psychological treatment of insomnia. Journal of Behavior Therapy and Experimental Psychiatry, 20, 143153.Google Scholar
Espie, C. A., Inglis, S. J., Harvey, L. and Tessier, S. (2000). Insomniacs’ attributions: psychometric properties of the Dysfunctional Beliefs and Attitudes about Sleep scale and the Sleep Disturbance Questionnaire. Journal of Psychosomatic Research, 48, 141148.Google Scholar
Field, A. (2005). Discovering Statistics using SPSS. (2nd edn.) London: Sage.Google Scholar
Foster, J. H., Marshall, E. J. and Peters, T. J. (1998). Impaired sleep in alcohol misusers and dependent alcoholics and the impact upon outcome. Alcoholism: Clinical and Experimental Research, 23, 10441051.Google Scholar
Gillin, J. C., Smith, T. L., Irwin, M., Buttos, N., Demodena, A. and Schuckit, M. (1994). Increased pressure for rapid eye movement sleep at time of hospital admission predicts relapse in non-depressed patients with primary alcoholism at 3-month follow-up. Archives of General Psychiatry, 51, 189197.CrossRefGoogle Scholar
Harvey, A. G. (2002). A cognitive model of insomnia. Behaviour Research and Therapy, 40, 869893.Google Scholar
Harvey, K. J. and Espie, C. A. (2004). Development and preliminary validation of the Glasgow Content of Thoughts Inventory (GCTI): a new measure for the assessment of pre-sleep cognitive activity. British Journal of Clinical Psychology, 43, 409420.Google Scholar
Hauri, P. J. (1997). Can we mix behavioural therapy with hypnotics when treating insomniacs? Sleep, 20, 11111118.Google Scholar
Krakow, B., Johnston, L., Melendrez, D., Hollifield, M., Warner, T. D., Chavez-Kennedy, D., et al. (2001). An open-label trial of evidence-based cognitive behaviour therapy for nightmares and insomnia in crime victims with PTSD. American Journal of Psychiatry, 158, 20432047.Google Scholar
Landolt, H. and Gillin, J. C. (2001). Sleep abnormalities during abstinence in alcohol-dependent patients: aetiology and management. CNS Drugs, 15, 413425.Google Scholar
Lichstein, K. and Rosenthal, T. (1980). Insomniacs’ perceptions of cognitive versus somatic determinants of sleep disturbance. Journal of Abnormal Psychology, 89, 105107.CrossRefGoogle ScholarPubMed
Morin, C. M. (1993). Insomnia: psychological assessment and management. New York: Guilford Press.Google Scholar
Morin, M. and Gramling, S. E. (1989). Sleep patterns and aging: comparison of older adults with and without insomnia complaints. Psychology and Aging, 4, 290294.Google Scholar
Morin, C. M., Stone, J., Trinkle, D., Mercer, J. and Remsberg, S. (1993). Dysfunctional beliefs and attitudes about sleep among older adults with and without insomnia complaints. Psychology and Aging, 8, 463467.Google Scholar
Ree, M. and Harvey, A. G. (2004a). Insomnia. In Bennett-Levy, C. et al. (Eds), Oxford Guide to Behavioural Experiments in Cognitive Therapy (pp. 287305). Oxford: Oxford University Press.Google Scholar
Ree, M. J. and Harvey, A. G. (2004b). Investigating safety behaviours in insomnia: the development of the sleep-related behaviours questionnaire. Behavior Change, 21, 2636.Google Scholar
Salkovskis, P. M. (1989). Cognitive-behavioural factors and the persistence of intrusive thoughts in obsessional problems. Behaviour Research and Therapy, 27, 677682.Google Scholar
Simeit, R., Deck, R. and Conta-Marx, B. (2004). Sleep management training for cancer patients with insomnia. Support Care Cancer, 12, 176183.Google Scholar
Sullivan, J. T., Sykora, K., Schneiderman, J., Naranjo, C. A. and Sellers, E. M. (1989). Assessment of alcohol withdrawal: the revised clinical institute withdrawal assessment for alcohol scale (CIWA-Ar). British Journal of Addiction, 84, 13531357.Google Scholar
Teplin, D., Raz, B., Daiter, J., Varenbut, M. and Tyrrell, M. (2006). Screening for substance use patterns among patients referred for a variety of sleep complaints. American Journal of Drug and Alcohol Abuse, 32, 111120.Google Scholar
Vitiello, M. V. (1997). Sleep, alcohol and alcohol abuse. Addiction Biology, 2, 151158.Google Scholar
Weissman, M. M., Greenwald, S., Nino-Murcia, G. and Dement, W. C. (1997). The morbidity of insomnia uncomplicated by psychiatric disorders. General Hospital Psychiatry, 19, 245250.Google Scholar
World Health Organization (1992). International Statistical Classification of Diseases and Related Health Problems (10th Revision). Geneva: WHO.Google Scholar
Zigmond, A. S. and Snaith, R. P. (1983). The Hospital Anxiety and Depression Scale. Acta Psychiatrica Scandinavica, 67, 361370.Google Scholar
Submit a response

Comments

No Comments have been published for this article.