Sleep Disturbances and Risk for Alcohol Disorders

说明（由申请人提供）：本申请的总体目的是 扩大和加强先前的工作， 失眠和其他睡眠障碍与酒精使用的发展 疾病和酗酒问题。 拟议分析的重点是 使用来自两个现有纵向研究的数据评估这些关联 调查：1）约翰霍普金斯先驱研究，和2）巴尔的摩ECA 随访研究。 当前应用程序的主要目标是评估 以下具体目的：1）测试失眠和其他睡眠 干扰与酗酒风险增加有关 使用，酒精滥用和依赖;以及这种关系是否不同 2）测试精神科合并症（如抑郁症）是否 症状，抑郁症，焦虑和精神痛苦）是 （3）评估是否有缓解 酒精滥用或依赖的睡眠障碍率高于 那些从不滥用酒精的人; 4）评估 自我报告失眠的酒精滥用和依赖者， 其他睡眠障碍，特别是测试是否预后 缓解，饮酒模式存在共病精神病理学，和 随后的睡眠模式对于患有酒精使用障碍的个体是不同的， 或饮酒问题，如果他们在基线时有失眠， 酒精滥用和依赖，或问题饮酒谁没有睡眠 扰动 失眠与精神分裂症关系的前瞻性分析 酒精使用障碍或有问题的饮酒很少，这些先前的 研究中，随访间隔相对较短。 我们建议 对两个经过充分研究的前瞻性数据集进行完整的二次分析， 随访间隔较长（巴尔的摩ECA随访的平均时间为13年， 约翰霍普金斯前驱体研究为36至50年）， 相对较低的研究损耗，如果成功完成， 我们对失眠和其他睡眠困难的理解， 有问题的饮酒行为和酒精滥用的长期风险因素，或 依赖 来自这些独特数据集的信息使我们能够 评估重要的中介作用，以及潜在的混淆和影响 改变特征，如抑郁症状的发生， 以及其他精神病理学和物质使用。 数据分析应 以具有成本效益的方式提供关于 失眠和酒精状况，这将有助于指导未来的实验， 观察性研究 结果可能会突出未来的潜在重点 调查预防和早期干预工作， 酒精滥用和依赖的发生率和流行率。

DESCRIPTION (Provided by applicant): The overall aim of this application is to extend and strengthen prior work which has examined the relationship of insomnia and other sleep disturbances with the development of alcohol use disorders and problem drinking. The focus of the proposed analyses is the assessment of these association using data from two existing longitudinal surveys: 1) the Johns Hopkins Precursors study, and 2) the Baltimore ECA Follow-up Study. The primary goal of the current application is to assess the following specific aims: 1) to test whether insomnia and other sleep disturbances are associated with an increased risk for problematic alcohol use, and alcohol abuse and dependence; and whether this relationship differs by sex; 2) to test whether psychiatric comorbidity (such as depressive symptoms , depressive disorders, anxiety, and psychiatric distress) are mediators of this relationship; 3) to assess whether those with remitted alcohol abuse or dependence have higher rates of sleep disturbance compared to those who never abused alcohol; and 4) to assess the natural history of individuals with alcohol abuse and dependence who self-report insomnia and other sleep disturbances, specifically to test whether the prognosis for remission, drinking patterns presence of comorbid psychopathology, and subsequent sleep patterns differ for individuals with an alcohol use disorder, or problem drinking, if they have insomnia at baseline relative to those with alcohol abuse and dependence, or problem drinking who have no sleep disturbance. Prospective analyses of the relationship of insomnia with alcohol use disorders or problematic drinking have been few and of these prior studies, the follow-up intervals have been relatively short. We propose to complete secondary analyses of two well-studied prospective data sets, that have long follow-up intervals (mean of 13 years for the Baltimore ECA Follow- up study, and 36 to 50 years for the Johns Hopkins Precursors Study), and relatively low study attrition, which if successfully completed can improve our understanding of insomnia and other sleep difficulties as potential long term risk factors for problematic drinking behavior and alcohol abuse or dependence. Information from these unique data sets allow the ability to assess important mediating, as well as potential confounding and effect modifying characteristics such as the occurrence of depressive symptoms as well as other psychopathology and substance use. The data analyses should provide, in a cost-effective manner, information on the relationship of insomnia and alcohol condition, which will help guide future experimental and observational studies. The results may highlight a potential focus for future investigations of prevention and early intervention efforts for reducing the incidence and prevalence of alcohol abuse and dependence.