Positive and negative reinforcement pathways underlying sleep and alcohol use associations

项目总结 意义：睡眠障碍与酒精使用量增加和酒精问题有关。这个 解释这种联系的机制还没有被很好地理解。这项拟议的研究将是第一个 考察既包括正强化路径(即，更高的冲动性和更高的冲动性)的综合模型 对酒精刺激作用的敏感度增加)和负强化途径(即更高 焦虑和对酒精的焦虑作用的敏感度增加)，这可能与睡眠障碍和 酒精问题。我们将使用严格的多方法方法，将实验室扩展到现实世界。 结果可能会通过确定哪些特定的睡眠因素导致风险以及原因，直接为AU的治疗提供信息。 目的：对于正强化通路，我们假设较晚的睡眠时间和较短的睡眠 持续时间预示着醉酒时的冲动更强，冲动和刺激的增加更大。为 负强化途径，我们假设睡眠效率较低，失眠的标志，将 预测在清醒时会有更高的焦虑，对酒精的焦虑反应会增加。这些流程将说明 睡眠因素与当前和预期的AU结局之间的关联。的专一性 我们将研究积极和消极的强化途径。我们还将探索性或诊断状态 (酒精使用障碍(AUD)，睡眠障碍)缓和睡眠特征和睡眠障碍之间的关系 通往非盟的增援道路。方法：年轻的成年饮酒者(21-30岁；50%女性；N=150) 将完成一项协议，包括生态瞬时评估(EMA)、实验室睡眠和酒精 反应评估和6个月的随访。参与者将是目前重度间歇性饮酒者(即5+ 在过去30天内，男性/女性摄入5+/4+的天数；SAMHSA)以确保足够的酒精摄入量 感兴趣的结果。我们将使用两种为期10天的EMA/Actigraph方案来跟踪日常睡眠特征 (时间、持续时间和效率)、焦虑、AU(频率5+/4+饮品/场合)、冲动和主观 现实世界中的酒精反应。每个EMA方案都将以一个通宵睡眠实验室结束 评估后在受试者内部进行实验室酒精注射(平衡：安慰剂/酒精 会议)，以检查酒精反应。在时间生物学实验室访问期间，我们将使用唾液DLMO来 评估生理昼夜节律。在酒精实验室探访期间，我们将测量阳性和阴性 通过主观反应(刺激/焦虑)和冲动(自我报告、任务)的强化途径。一辆90- 6个月后提交的日时间表后续面谈将允许前瞻性检查 睡眠特征与后来的AU之间的关联(频率5+/4+饮品/场合)和问题。这个 拟议中的研究将提供有关睡眠障碍如何影响睡眠的新信息。 酒精反应和冲动。这些发现可能直接转化为预防/治疗澳门氏症的努力。

PROJECT SUMMARY Significance: Sleep disturbances are related to increased alcohol use (AU) and alcohol problems. The mechanisms that account for this association are not well understood. The proposed study will be the first to examine an integrative model including both a positive reinforcement pathway (i.e., higher impulsivity and increased sensitivity to the stimulating effects of alcohol) and a negative reinforcement pathway (i.e., higher anxiety and increased sensitivity to the anxiolytic effects of alcohol) that may link sleep disturbances and alcohol problems. We will use a rigorous multi-method approach that extends the laboratory into the real world. Results may directly inform AU treatment by identifying which specific sleep factors contribute to risk and why. Aims: For the positive reinforcement pathway, we hypothesize that later sleep timing and shorter sleep duration will predict higher impulsivity and greater increases in impulsivity and stimulation while intoxicated. For the negative reinforcement pathway, we hypothesize that lower sleep efficiency, a marker of insomnia, will predict higher anxiety while sober and increased anxiolytic response to alcohol. These processes will account for the association between sleep factors and concurrent and prospective AU outcomes. Specificity of the positive and negative reinforcement pathways will be examined. We will also explore if sex or diagnostic status (alcohol use disorder (AUD), sleep disorders) moderate the relationships between sleep characteristics and reinforcement pathways to AU. Approach: Young adult drinkers (21-30 years of age; 50% female; N = 150) will complete a protocol that includes ecological momentary assessments (EMA), laboratory sleep and alcohol response assessments, and 6-month follow-up. Participants will be current heavy episodic drinkers (i.e., 5+ days in past 30 days of consuming 5+/4+ for males/females; SAMHSA) to ensure sufficient range in alcohol outcomes of interest. We will use two 10-day EMA/actigraphy protocols to track daily sleep characteristics (timing, duration, and efficiency), anxiety, AU (freq. of 5+/4+ drinks/occasion), impulsivity, and subjective alcohol response in the real world. Each EMA protocol will conclude with an overnight sleep laboratory assessment followed by a within-subjects laboratory alcohol administration (counterbalanced: placebo/alcohol sessions) to examine alcohol response. During the chronobiology lab visits, we will use salivary DLMO to assess physiological circadian timing. During the alcohol lab visits, we will measure positive and negative reinforcement pathways via subjective response (stimulation/anxiety) and impulsivity (self-report, tasks). A 90- day timeline follow-back interview delivered 6 months later will allow for the prospective examination of associations between sleep characteristics and later AU (freq. of 5+/4+ drinks/occasion) and problems. The proposed study will provide novel information about how sleep disturbances, a set of modifiable factors, affect alcohol response and impulsivity. These findings may directly translate to prevention/treatment efforts for AUD.