Using Alcohol for Sleep: A Sign of Unhealthy Use
Insomnia and other sleep disturbances are common in primary-care settings. Investigators analyzed data on sleep and alcohol use reported by 1699 patients who saw 1 of 94 family physicians participating in a research network.
- Hours of sleep, quality of sleep, trouble sleeping or staying awake, sleep apnea, and use of sleep medication were not significantly associated with unhealthy alcohol use.*
- However, 62% of patients who reported using alcohol to help them sleep at least once a month had unhealthy alcohol use, while only 19% of those who did not use alcohol for sleep had unhealthy use (odds ratio 4.5 for unhealthy versus moderate† use in models adjusted for age, sex, education, and physician visited).
*Defined as an Alcohol Use Disorders Identification Test–Consumption (AUDIT-C) score of ≥4 or for men and ≥3 for women, or answering yes to 1 of 2 questions about drinking more than intended or in situations where the patient could have been hurt.
†Consumed alcohol but did not meet criteria for unhealthy use.
Comments:
The fact that this study did not find an association between drinking and sleep disturbances is likely related to sampling and methodological issues and does not mean the well-documented effects of alcohol on sleep don’t exist. The take-home message, however, is that if a patient reports using alcohol for sleep, the clinician should suspect unhealthy alcohol use and confirm its presence or absence.
Richard Saitz MD, MPH
Reference:
Vinson DC, Manning BK, Galliher JM, et al. Alcohol and sleep problems in primary care patients: a report from the AAFP National Research Network. Ann Fam Med. 2010;8(6):484–492.