Graduation Year

2025

Document Type

Thesis

Degree

M.A.

Degree Name

Master of Arts (M.A.)

Degree Granting Department

Psychology

Major Professor

Robert Schlauch, Ph.D.

Committee Member

Jack Darkes, Ph.D.

Committee Member

Ruthann Atchley, Ph.D.

Keywords

Alcohol Use, Psychotherapy, Sleep, Treatment Outcomes

Abstract

Sleep disturbances are highly prevalent among individuals with AUD. Sleep and alcohol have a bidirectional relationship such that alcohol damages sleep-promoting brain regions, and impaired sleep exacerbates cognitive and emotional deficits that can promote alcohol use. Despite the evidence that sleep improves across treatment for AUD, these improvements have had inconsistent associations with treatment outcomes. This may result from previous research focusing solely on mean values of sleep parameters rather than daily within-person variability. Sleep variability is emerging as an important correlate of physiological dysregulation and is connected to a range of negative symptoms that may promote alcohol use. The current study longitudinally assessed sleep variability among a sample of adults (N = 80) receiving a 12-week psychotherapy treatment for AUD to examine changes in sleep variability and associations with treatment outcomes. Results indicated that variability in sleep midpoint (vSM), but not total sleep time (vTST), decreased across treatment. Changes in vSM were not associated with any treatment outcomes, but reductions in vTST predicted reductions in psychological distress. Exploratory analyses showed variability in sleep onset latency (vSOL), sleep efficiency, and number of awakenings (vAwake) also decreased across treatment. Further, reductions in vSOL and vAwake predicted improvements in alcohol-related outcomes. Finally, exploratory analyses showed that none of the sleep variability parameters predicted changes in potential mechanistic processes. Results provide evidence that variability in sleep is a predictor and modifiable treatment target for AUD treatment outcomes above and beyond mean-value sleep parameters. Future research would benefit from further examination into what drives changes in sleep variability, as well as potential added benefits of adapting AUD treatments to include components that target improving consistency in sleep patterns and sleep-related behaviors.

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