Addressing Hazardous and Harmful Alcohol use Through an Adapted CBT Sleep Intervention

项目摘要/摘要 饮酒问题和睡眠问题都会在个人和社会层面造成重大损失。失眠在 尤其是在酒精使用障碍患者中非常普遍，可能与 酒精使用障碍的发展，并有助于在酒精治疗后较差的恢复预后。 因此，失眠是与饮酒相关的负面后果的一个可改变的风险因素。 在酒精使用问题的整个连续体上。 因此，该项目建议通过针对以下个人量身定做的失眠干预措施来改善睡眠 符合被广泛接受的危险饮酒定义以及失眠障碍的诊断标准。 这是一项治疗发展研究，将使认知行为疗法适用于成人失眠。 从事危险的饮酒行为。我们提出了一种迭代的方法来开发、细化和 电话传递的4次认知行为疗法的效用的初步检验 用于适应危险酒精使用者的失眠。 该项目将从一个小型的开放标签试点开始，以制定和完善管理程序 干预。然后，我们将进行一项小型随机试验，将干预与睡眠和饮酒进行比较 教育控制条件。由于这是一个治疗发展奖，我们将评估一些干预措施 和研究设计可行性领域，为设计更大规模的研究做准备。我们还将评估影响 对酒精使用、睡眠和情绪的干预，通过测量这些结果在基线，治疗后， 在3个月和6个月的随访评估中。 总而言之，这项提议是一项研究计划的第一步，该计划打算利用睡眠作为杠杆来改变 危险饮酒的过程。在这里，第一步是调整已经成功的失眠干预措施，以 并对该干预措施对患者的可接受性、保真度进行初步测试 治疗师，以及对饮酒、睡眠和情绪的影响。如果研究结果令人振奋，我们将利用这些数据和 收集了有关研究方法的信息，以进行下一阶段的研究：设计和实施 一项权威的研究，旨在测试我们的失眠干预措施减少酒精使用和改变失眠过程的能力 危险的酒精使用。

Project Summary/Abstract Drinking problems and sleep problems each cause significant loss at individual and societal levels. Insomnia in particular is highly prevalent in patients with alcohol use disorder, is prospectively associated with the development of alcohol use disorder and contributes to poorer recovery prognosis following alcohol treatments. Insomnia, therefore, represents a modifiable risk factor for negative outcomes associated with alcohol use along the full continuum of alcohol use problems. Accordingly, the project proposes to improve sleep with an insomnia intervention tailored to individuals who meet widely accepted definitions for hazardous alcohol use as well as diagnostic criteria for insomnia disorder. This is a treatment development study that will adapt cognitive behavioral therapy for insomnia for adults engaged in hazardous use of alcohol. We propose an iterative approach to development, refinement, and preliminary examination of the utility of a telephone-delivered, 4-session version of cognitive behavioral therapy for insomnia adapted to hazardous alcohol users. The project will begin with a small, open label pilot to develop and refine procedures for administering the intervention. Then, we will conduct a small, randomized trial comparing the intervention to a sleep and alcohol education control condition. As this is a treatment development award, we will assess a number of intervention and study design feasibility domains in preparation for designing a larger study. We will also assess the effects of the intervention on alcohol use, sleep and mood by measuring these outcomes at baseline, post-treatment, and at 3- and 6-month follow up assessments. In sum, this proposal is the first step in a program of research that intends to use sleep as a lever to alter the course of hazardous alcohol use. Here, the first step is to adapt an already successful insomnia intervention to a unique population and conduct a preliminary test of that interventions’ acceptability to patients, fidelity by therapists, and effects on drinking, sleep and mood. If study results are promising, we will use these data and information gleaned about the study methods to pursue the next phase of research: designing and conducting a definitive study to test our insomnia intervention’s capacity to decrease alcohol use and modify the course of hazardous alcohol use.