Member Research and Reports

Member Research and Reports

Brown: Insomnia Severity Impacts Symptoms of Depression and PTSD on Alcohol Use and Related Consequences in Veterans

Excessive alcohol consumption is one of largest barriers to physical and mental health in the U.S. It is especially concerning among military personnel. Heavy-drinking service report higher levels of general stress, anxiety, depression, posttraumatic stress, and suicidal ideation than their lower-drinking counterparts. Such high rates of mental health disorders in comparison to civilian samples, combined with the perceived stigma of mental health treatment, place heavy-drinking service members and Veterans at increased risk for negative health outcomes. Previous findings suggest that symptoms of depression and PTSD significantly increase risk for heavy drinking and alcohol-related consequences among military service members and Veterans. One symptom shared across multiple mental health disorders is difficulty falling or staying asleep. Depression and PTSD have both been linked to symptoms of insomnia in military and Veteran populations. In turn, symptoms of insomnia have been linked to heavy drinking and alcohol-related consequences among military samples.

[Photo: Dr. Mary Beth Miller]

This study, led by Dr. Mary Beth Miller, adjunct assistant professor of behavioral and social sciences (research), tested three hypotheses. First, given previous research linking mental health to alcohol use outcomes, study authors hypothesized that baseline symptoms of depression and PTSD would predict alcohol use and related consequences one month later. Second, they expected symptoms of depression and PTSD to predict greater insomnia severity at one month. Finally, authors hypothesized that insomnia severity at one month would mediate the association between baseline symptoms of both depression and PTSD and alcohol use and consequences reported one month later.

The study authors found that approximately half of the participants reported clinically significant symptoms of insomnia and depression, and more than a third met screening criteria on a self-report measure of PTSD. The prevalence of these mental health issues and their respective influences on alcohol-related outcomes indicate a need to prevent and treat these problems in young adults who have been discharged from military service. They also found that symptoms of neither depression nor PTSD had direct effects on drinking quantity, and only symptoms of depression had a direct effect on alcohol-related consequences. Despite lack of direct mental health effects on alcohol-related outcomes, symptoms of both depression and PTSD predicted symptoms of insomnia one month later, and insomnia severity was a concurrent predictor of alcohol use and consequences.

Symptoms of depression and PTSD increase risk for alcohol use and related consequences in part by increasing symptoms of insomnia. This study finds that insomnia may be an appropriate target for prevention and intervention efforts among heavy-drinking Veterans reporting symptoms of depression or PTSD. Given the prevalence and significance of insomnia symptoms in Veterans, increased efforts to prevent and intervene in sleep problems within this population are warranted.

This study was published in Drug and Alcohol Dependence, Volume 177, 1 August 2017.

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