Automated insomnia intervention found to improve both sleep and hazardous alcohol use

An online treatment for insomnia may improve both sleep and problem drinking patterns in people who drink heavily, according to a study in Alcohol: Clinical and Experimental Research.

Researchers found that heavy drinkers who received web-based cognitive behavioral therapy designed to treat their insomnia had greater improvement in sleep and drinking behaviors compared to people who were given access to online education to improve their sleep.

This is the first study to show that cognitive behavioral therapy for insomnia can lead to significant reductions in alcohol consumption among heavy drinkers. The findings support the use of self-administered online health interventions, which may help overcome barriers to treatment for people at high risk.

The study compared the sleep and drinking outcomes of two groups of heavy drinkers with insomnia. One group was given a validated, interactive, online cognitive behavioral therapy program, while a control group received unlimited access to online educational resources to address insomnia.

Both groups experienced improvements in sleep and drinking, but the group using the digital cognitive behavioral intervention, called SHUTi, saw greater improvement.

Following the nine-week intervention, the digital cognitive behavioral program participants showed a more pronounced decrease in alcohol consumption measures over time compared to the control group. SHUTi users reported significantly lower insomnia severity and significantly improved sleep quality compared to participants in the control group and maintained lower insomnia severity scores at six months.

At six months, the sleep quality scores were the same for both groups due to improvements in sleep quality in the control group.

Researchers note that SHUTi is the first digital cognitive behavioral therapy intervention for insomnia to result in reductions in alcohol consumption among people with hazardous drinking behaviors and insomnia. Digital cognitive behavioral therapy has the potential to improve access to treatment for people with alcohol use disorder who may not otherwise seek treatment due to barriers such as stigma or lack of transportation.

Women, in particular, are more likely to receive treatment for alcohol problems in alternative settings and show a stronger association between poor sleep quality and alcohol-related problems.

The SHUTi program used for the study is entirely online and automated and provides individualized feedback based on participants' sleep data and other self-reported information. Participants complete a series of interactive modules based on principles of cognitive behavioral therapy for insomnia.

The study, conducted from September 2020 to September 2021, included 71 men and women ages 21 to 50. Participants were considered to be hazardous drinkers who experienced insomnia for three or more nights per week for the past three months.

The researchers recommend further studies with a more significant number of and more diverse participants to identify whether outcomes are influenced by other factors, such as marriage, caregiving, education status, sleep aid use, age, sex, and circadian preferences.