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Management of Insomnia in Patients with Alcohol Use Disorder

  • Behavioral Therapy (J Edinger, Section Editor)
  • Published:
Current Sleep Medicine Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

Persistence of insomnia during recovery from alcohol use disorders (AUD) is common and associated with drinking relapse and suicidal ideation. Therefore, insomnia intervention is often warranted for AUD patients. This review critically evaluates current literature on approaches to insomnia management in recovering AUD patients.

Recent Findings

Recent work has bolstered support for cognitive-behavioral therapy as the first-line intervention for insomnia in AUD patients, although more work is needed to determine its effects on drinking outcomes. Recent initial evidence suggests that CBT for insomnia delivered online improves insomnia and drinking outcomes. Finally, gabapentin is the most evidence-based medication for improving both sleep disturbance and drinking outcomes in AUD patients, but controlled studies are warranted on melatonin receptor agonists, which have low risk of abuse and could target identified circadian rhythm abnormalities in this population.

Summary

Ongoing monitoring and treatment of insomnia in AUD is frequently indicated, and several behavioral and pharmacological sleep-focused interventions have garnered initial empirical support. However, the evidence base for insomnia treatments in recovering AUD patients is limited, and future research is warranted to establish more definitely their effectiveness and predictors of insomnia and drinking outcomes.

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Authors and Affiliations

  1. Sleep and Circadian Research Laboratory, Department of Psychiatry, University of Michigan Medical School, 4250 Plymouth Road, Ann Arbor, MI, 48109-2700, USA

    Jessica R. Schubert & J. Todd Arnedt

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  1. Jessica R. Schubert
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  2. J. Todd Arnedt
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Correspondence to Jessica R. Schubert.

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Jessica R. Schubert declares no potential conflicts of interest.

J. Todd Arnedt reports grants from American Sleep Medicine Foundation and personal fees from UpToDate, Magna Seating, and Springer International Publishing.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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This article is part of the Topical Collection on Behavioral Therapy

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Schubert, J.R., Todd Arnedt, J. Management of Insomnia in Patients with Alcohol Use Disorder. Curr Sleep Medicine Rep 3, 38–47 (2017). https://doi.org/10.1007/s40675-017-0066-3

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