Sleep Disturbances and Risk for Alcohol Disorders

描述(由申请人提供)：本申请的总体目标是 扩大和加强以前的工作，审查了 失眠和其他睡眠障碍与酒精使用的发展 精神障碍和酗酒问题。建议分析的重点是 使用现有的两个纵向数据来评估这些关联 调查：1)约翰·霍普金斯先驱研究，2)巴尔的摩非洲经委会 随访研究。当前应用程序的主要目标是评估 具体目标如下：1)测试失眠和其他睡眠 精神障碍会增加问题酒精的风险。 使用、酗酒和依赖；以及这种关系是否不同 通过性别；2)测试精神疾病的共病(如抑郁 症状、抑郁障碍、焦虑和精神困扰)是 这种关系的调解人；3)评估那些病情缓解的人 酗酒或依赖睡眠障碍的比率比 那些从不酗酒的人；以及4)评估 有酒精滥用和依赖的个人，自我报告失眠和 其他睡眠障碍，特别是测试预后是否为 缓解，饮酒模式，存在共病的精神病理，以及 随后的睡眠模式对于酒精使用障碍的人来说是不同的， 或者有问题的饮酒，如果他们有失眠的基线相对于那些 酗酒和依赖，或失眠的酗酒问题 骚乱。失眠与精神疾病关系的前瞻性分析 酒精使用障碍或有问题的饮酒一直很少，而且在此之前 研究发现，随访间隔时间相对较短。我们建议 对两个经过充分研究的预期数据集进行完整的二次分析，即 有很长的随访间隔(巴尔的摩非洲经委会的随访平均为13年- UP研究，约翰霍普金斯前体研究36年至50年)，以及 相对较低的学习流失率，如果成功完成，可以改善 我们对失眠和其他睡眠困难的理解是潜在的 问题饮酒行为和酗酒的长期危险因素或 依赖。来自这些独特数据集的信息使我们能够 评估重要的调解以及潜在的混淆和影响 将抑郁症状的出现等特征修改为 以及其他精神病理学和药物使用。数据分析应该 以具有成本效益的方式提供关于下列关系的信息 失眠和酒精状况，这将有助于指导未来的实验和 观察性研究。这一结果可能会突出未来的潜在焦点 开展预防和早期干预工作的调查，以减少 酗酒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.