Given the scope of the alcohol problem in the US, our interdisciplinary team has come together with two distinct scientific outlooks to examine the interaction of alcohol and sleep with neurocognitive performance and whether this interaction may help identify strategies to improve treatment outcomes for alcohol use disorders (AUD). AUD psychosocial treatments have been developed that span a number of approaches, but all such interventions depend on intact cognitive function to be effective. Many aspects of neurocognitive function required to learn and apply psychosocial skills, however, are adversely affected by repeated alcohol use and sleep disturbance. Effective use of the skills taught by psychotherapy requires neurocognitive functioning consistent with 1) learning skills, 2) assessing the need for skills both ahead of time and in the moment, and 3) implementing skills when needed. The combination of continued heavy alcohol use and associated sleep disruption likely prevents patients' realizations of the full benefits of effective psychosocial interventions. Approaches to improving sleep in the context of AUD and psychosocial interventions must target aspects of sleep most predictive of impaired neurocognitive functioning, particularly under conditions of repeated alcohol use. The effects of serial (i.e., multi-night) alcohol administration and sleep disruption and their interactive effect on neurocognitive function are unknown. Furthermore, there is a notable lack of alcohol and sleep- related laboratory research in mature adults (defined as 35-50), including assessment of potential male-female differences. Our approach is to test sleep and next-day neurocognitive effects in mature heavy-drinking adults after administering alcohol (targeted BAC of .1g%) on consecutive nights in a controlled laboratory setting under three sleep conditions: nominal (drinking followed by 8.5 h sleep on ?usual sleep schedule?), delayed (drinking followed by 8.5 h sleep 3 h later than usual sleep), and delayed/restricted (drinking followed by 5.5 h sleep 3 h later than usual). These study conditions provide the opportunity to explore neurocognitive consequences of alcohol's effects on sleep, but also to pursue fundamental research questions. These studies will 1) assess the influence of 3 nights' alcohol administration under 3 sleep conditions (nominal, delayed, delayed/restricted) on next-day neurocognitive performance and alertness/sleepiness; 2) assess the associations among serial nightly alcohol administration, rate of alcohol metabolism, and 3 sleep conditions and sleep physiology; and 3) we will explore sleep and alcohol variables for mechanistic influences on next- day neurocognitive functioning.
The impact of alcohol on sleep and next day cognitive function may have profound implications for individuals with alcohol problems. Alcohol use likely disrupts sleep in a fashion that impairs cognitive function the next day. Alcohol and sleep-disruption may result in impairment in such cognitive domains as executive function and learning as well as sleepiness that actually perpetuate the problematic alcohol use. While some evidence of these associations exists in young adults, there is remarkably little research addressing these phenomena in mature adults who are less cognitively resilient than young adults, in women as compared to men, or over multiple night of alcohol exposure (that most likely mimics alcohol use in those with alcohol use disorders). Accordingly, this proposal sets out to fill fundamental gaps in knowledge in the relationships between alcohol, sleep and next day cognitive function after multiple nights of alcohol consumption in mature heavy-drinking adults. Findings from these studies may provide key insights into these problems and point to treatment targets that will improve the outcomes of individuals who are trying to stop drinking.
