Sleep Health and Alcohol Use

Problematic alcohol use and poor sleep health are prevalent, highly comorbid disorders that create a burden on the healthcare system. This chapter reviews decades of research supporting the bidirectional association between alcohol and sleep. Experimental and clinical studies show that alcohol use affects sleep physiology and subjective reports of insomnia symptoms, while prospective studies show that insomnia symptoms predict heavy drinking and alcohol-related problems. Despite these findings, the causal nature of the alcohol and sleep association is not well understood. In particular, the potential mechanism(s) linking insomnia symptoms to subsequent alcohol use outcomes (e.g., impairments in cognition, reward systems, emotion regulation) are unclear. However, because insomnia symptoms can persist for years following successful alcohol treatment and sustained sobriety, direct intervention for insomnia is often indicated for individuals with alcohol use disorders. The methodological limitations of existing research provide direction for future research.