Sleep disturbance is associated with greater subjective and neural negative emotionality in people with alcohol use disorder

BACKGROUND Sleep disturbance is ubiquitous in alcohol use disorder (AUD). Sleep disturbance within AUD has been mapped onto the three-stage addiction cycle. The Addictions Neuroclinical Assessment (ANA) is a neuroscience-based framework, which measures functional domains that correspond to the stages of the addiction cycle. The present study investigated the relationship between sleep disturbance and AUD neuroclinical phenomenology and underlying neurobiology.

METHODS In two independent studies, participants completed assessments of sleep disturbance through the Pittsburgh Sleep Quality Index (PSQI; n = 115) or the Insomnia Severity Index (ISI; n = 102). A subset of individuals (n = 52) completed a functional magnetic resonance imaging scan to assess the neurobiology of the incentive salience and negative emotionality domains.

RESULTS Both studies found that sleep disturbance was associated with negative emotionality (ps≤0.001), but not incentive salience (ps>0.14) or executive function (p = 0.62). Individuals with sleep disturbance had greater activation in the frontal pole, anterior cingulate, medial frontal cortex, and posterior cingulate cortex when viewing negative vs. neutral images, compared to those without sleep disturbance, indicating an underlying neural substrate for the heightened negative emotionality neuroclinical profile.

CONCLUSIONS These results suggest that sleep disturbances in AUD are associated with a neurofunctional profile of enhanced negative emotionality and identify a potential neurobiology underlying this association. These findings suggest that sleep disturbance may be a promising treatment target to improve negative emotionality in this group.