Post-traumatic stress disorder (PTSD), sleep disturbance and alcohol problems are common among military veterans, and often occur together, with a large toll on physical and mental health. A new study published in the journal Alcoholism: Clinical & Experimental Research examines the interplay of PTSD symptoms and disturbed sleep, and how they affect the risk of alcohol problems over time.
Researchers from Missouri, Rhode Island and California universities and Veteran healthcare services analyzed data from 325 Veterans of the Iraq/Afghanistan era who reported recent alcohol use. Participants provided information on alcohol problems, sleep disturbance, and intrusive thoughts around trauma (a key symptom of PTSD) at three timepoints ─at the start of the study (baseline), after six months, and after 12 months. Using statistical modeling, the research team assessed the links between intrusive thoughts and sleep disturbance reported at baseline or six months and their association with alcohol problems after one year.
Consistent with previous research, the results showed that Veterans with baseline PTSD symptoms were also more likely to have sleep disturbance at six months, and vice versa. Having intrusive thoughts about trauma at baseline was directly associated with having more alcohol problems at one year, even after accounting for sleep disturbance. Sleep disturbance at baseline was not directly associated with alcohol problems at one year, but was linked to intrusive thoughts about trauma at 6 months, which were associated with alcohol problems at one year. This suggests that intrusive thoughts about trauma help explain the association between sleep disturbance and alcohol-related problems ─ whereas the converse (sleep disturbance explaining the association between intrusive thoughts and alcohol problems) does not appear to be true.
These findings help explain the long-term association between sleep and alcohol problems among Veterans. The researchers note that because Veterans may be more willing to seek treatment for sleep disturbance than for other mental health issues, sleep could be an important treatment target for Veterans with PTSD and alcohol use disorder.
Miller, M.B. et al. (2019) Longitudinal Associations between Sleep, Intrusive Thoughts, and Alcohol Problems Among Veterans. Alcoholism: Clinical and Experimental Research. doi.org/10.1111/acer.14191.