A new study gives us more insight into how stress, depression, insomnia, and heavy drinking are all linked. It goes a significant way towards untangling the complicated relationship that all four of these issues have with each other.
According to the study team, from the University of Kentucky, the University of Miami, and Ohio State University, these findings could help in the development of new treatments for both sleeping issues and excessive alcohol consumption.
The starting point for the research: lots of people who have alcohol use disorder (AUD) also have trouble sleeping. One of the key aims of this study was to see whether stress and depression might be part of the explanation for this link.
"The number of people with AUD who also have insomnia is very, very high," says psychologist Jessica Weafer of Ohio State University. "It's striking, and important."
The researchers surveyed 405 people who both drank heavily and showed symptoms of insomnia. The study participants were asked about these two issues, as well as the levels of stress they felt, and any signs of depression they were experiencing.
An analysis of the data showed two key patterns: insomnia leading to stress, which then seems to trigger heavy drinking; and heavy drinking leading to depression, which then apparently triggers insomnia. Stress looks like a key mediating factor in one direction, while depression is the important mediating factor in the other direction.
The information here represents just a snapshot in time, and there are so many different elements potentially contributing here – maybe causing all four of these problems together, even – that it's difficult to be definitive about the health implications.
However, the findings are still very useful, teasing out some of the underlying reasons why insomnia and AUD so often go together.
"There are so many different pathways that could explain insomnia and alcohol use. We wanted to connect the dots and see if there's anything there," says cognitive neuroscientist Justin Verlinden of the University of Kentucky.
"When you put both stress and depression in the same models, that's where we get unique findings, even though there are a lot of shared characteristics between stress and depression."
Next, the researchers want to run a similar study over the course of 12 months, which should give them a better idea of how one issue might lead to others, and which problems could develop along the way.
It's not difficult to see how all of these health worries could be connected, or to see the difficulty in trying to separate them. The better our understanding of the causes and effects, though, the better informed we can be in trying to manage them.
"Identifying these types of mediating factors can have important treatment implications," says Weafer. "That's the long-term ideal, or hope, that this work could have an impact on treatment."
The research has been published in Alcohol.