Schlafstörungen und schlafhygiene bei alkoholabhängigen

Background: Alcoholics frequently complain about sleep difficulties. Some alcoholics even attribute their elevated consumption of alcohol to their sleep disturbances. Although sleep hygiene is considered an important tool to reduce sleep disturbances, there is a paucity of data concerning sleep hygiene in alcoholics. Aim: This study was designed to examine whether there was a relationship between self-reported sleep disturbances and a lack of sleep hygiene in alcoholics. Methods and sample: 144 chronic alcoholic males and females (mean age: 43.3 ± 10.4 years) consecutively referred to our department were administered a newly developed questionnaire on their sleep behaviour and sleep hygiene. Results: 65 (45.1%) of the investigated alcoholics complained of severe sleep disturbances occurring more than once a week during the last year prior to index admission. These alcoholics did not differ from those without sleep disturbances with respect to sleep hygiene (defined by taking steps to sleep more easily). However, while only a third of the investigated alcoholics took any steps, more than half of them drank alcoholic beverages immediately before going to bed. The alcoholics complaining of sleep disturbances more frequently attributed their sleep difficulty to a depressive mood or anxiety rather than to their alcohol consumption. The sleep difficulties occurred prior to relapse as well as during the last drinking period. Severe sleep disturbances were frequently reported in the month prior to the last relapse. Conclusion: Our results show that a lack of sleep hygiene is very common among alcoholics irrespective of sleep disturbances. An education to sleep hygiene should be considered before hypnotics are prescribed in order to lower the risk of another drug dependency. Moreover, our results suggest that sleep difficulties occur more frequently in those alcoholics reporting anxiety or depressive mood and often precede relapse. A training in sleep hygiene or even more intensive treatment approaches to the sleep disturbances might thus help to decrease the risk of relapse.