0320 Improvements in Sleep & Drinking Outcomes Among Heavy Drinkers Following a Digital CBT-I Program

Abstract

Abstract Introduction Insomnia and Alcohol Use Disorder (AUD) and are highly comorbid, due in part to the use of alcohol as a sleep aid among individuals with insomnia. Initial studies have shown that cognitive behavioral therapy for insomnia (CBT-I), the first-line treatment for insomnia, is moderately successful at improving both sleep and drinking outcomes in heavy drinkers with insomnia. However, CBT-I is not widely available. Digital CBT-I could be a more accessible alternative. One digital CBT-I program, Sleep Healthy Using the Internet (SHUTi), is especially promising due to its high efficacy in treating insomnia and its individualized and interactive platform. Here we conducted a pilot study to examine the efficacy of SHUTi on improving sleep and drinking outcomes in a sample of heavy drinkers with insomnia. Methods Heavy drinking men and women with insomnia (n=53) were randomly assigned to complete the SHUTi program (n=26) or a nine-week patient education control program (n=27). Questionnaires examining sleep (Insomnia Severity Index and Pittsburgh Sleep Quality Index) and alcohol use (30-day Timeline Follow-Back) were completed pre-intervention, post-intervention, and 3-months post-intervention. Linear mixed effect models were used to examine the effects of SHUTi on sleep and alcohol consumption and whether any effects of SHUTi on drinking were mediated by the effects of SHUTi on sleep. Results SHUTi significantly improved sleep (ISI & PSQI; ps ≤ .021) and drinking outcomes (past 30-day total drinks, drinking days, and binge episodes; ps ≤ .032) over time relative to the control condition. Additionally, the effects of SHUTi on drinking quantity, but not frequency, were mediated by SHUTi’s effects on sleep. Conclusion These results show that SHUTi is an effective intervention for improving sleep among heavy drinkers with insomnia. Further, they suggest that sleep may be an effective treatment target to slow the progression of AUD in at-risk individuals. Together, these findings provide preliminary support for the implementation of an inexpensive, easily accessible health behavior intervention with significant public health impact in a high-risk population. Support (if any)