UK researchers 1st to track app’s effect on heavy drinkers with insomnia

University of Kentucky researchers in the College of Arts and Sciences and College of Public Health are the first in the country to study a digital intervention method’s impact on interrelated public health issues: heavy drinking and insomnia.

The two-year, nearly $400,000 grant from the National Institute on Alcohol Abuse and Alcoholism (NIAAA) will fund research on how an intervention program called Sleep Healthy Using the Internet (SHUTi) will improve participants’ sleep and indirectly improve their drinking habits.

SHUTi is an online version of cognitive behavioral therapy for insomnia, a common sleep disorder marked by trouble falling asleep, staying asleep or getting good quality sleep. The program can be accessed through an app on a smartphone or online.

Mairead Moloney, Ph.D., an associate professor in sociology, and Jessica Weafer, Ph.D., an assistant professor in psychology, are the study’s principal investigators. Michelle Martel, Ph.D., director of clinical training and professor in psychology, and Olga Vsevolozhskaya, Ph.D., an assistant professor in biostatistics, serve as co-investigators in the study. Justin Verlinden, a cognitive neuroscience Ph.D. student in Weafer’s lab, is the project’s graduate research coordinator.

“It’s been well-tested and well-validated to improve people’s sleep,” said Verlinden regarding SHUTi. “The novelty of this is that we’re testing it in this sample of heavy drinkers and seeing the outcomes.”

In a previous study led by Moloney, researchers found that the program had positive spillover effects besides bettering sleep, like improving stress levels, depression, coping skills and trauma symptoms. A subsequent pilot study co-led by Moloney and Weafer found that SHUTi also reduced drinking among heavy drinkers.

“Insomnia is very common and not stigmatized, while alcohol use disorder is highly stigmatized and increasingly common,” said Moloney. “If we can tackle both of these public health issues with a simple, effective, accessible intervention then we could seriously improve public health.”

Alcohol use disorder (AUD), commonly referred to as alcoholism, is an urgent and escalating public health problem estimated to cost the United States $249 billion per year. Insomnia often precedes problematic drinking.

UK researchers are using SHUTi to specifically look at improvements in a larger sample of heavy-drinking adults. They’re looking at broad differences between the sexes and if there’s a more pronounced effect in women.

“We know that heavy drinking among women is a particular emergent public health issue. It’s our hope that SHUTi will have helpful impacts for women,” said Moloney.

The NIAAA defines heavy drinking for women as consuming more than three drinks in a day or more than seven per week and for men more than four a day or 14-plus per week.

UK researchers have promising preliminary data that shows the insomnia intervention is reducing heavy drinking in women and they hope to help the understudied group.

“We might be able to reach people with this insomnia intervention that might not necessarily seek out treatment for AUD. Women are less likely to seek treatment for AUD than men might be, but perhaps more likely to seek treatment for a sleep problem,” said Weafer.

Roughly 187,000 Kentuckians age 12 or older have AUD, according to a 2019 report by the Substance Abuse and Mental Health Services Administration. Researchers say those rates increased during the pandemic along with the rate of insomnia.

“We can address two different really important issues that are affecting public health, especially since the pandemic, and I think that if we can do that, that’d be huge,” said Verlinden.

“This has real positive impacts for public health if we can have an easily accessible, effective intervention that people can just log on to their phones or their computers, do it in the comfort of their own homes, and this intervention could both improve their sleep and improve their drinking habits,” said Moloney.

Researchers say the use of technology to access SHUTi also helps them with younger participants through an engaging and easily accessible intervention.

“Young adults are at high risk for developing AUD and problematic drinking, in general. The population is very unlikely to go seek treatment in a traditional medical setting, but they’re very likely to do something on their phone,” said Weafer.

“With the SHUTi program, they can do the work on their own time or start and stop,” said Verlinden. “I think the interactive components of everything make it more likely for these people to be engaged and stay engaged compared to a more traditional face-to-face interaction.”

For this study, researchers are expanding the age range for participants to 18 to 50 with the hope of seeing trends across different age groups. They hope to begin recruiting soon.

This study builds on preliminary data gathered through internal funding from a Substance Use Priority Research Area (SUPRA) pilot grant. SUPRA, one of UK’s seven Research Priority Areas, funds pilot studies with the goal to increase UK researchers’ competitiveness for external funding and expand UK’s federal substance use research portfolio.

“I think we’re on a really exciting path, and that’s, in large part, thanks to our start with UK,” said Moloney. “It’s also allowed us to combine our complementary strengths on this project to create important collaborations that we couldn’t otherwise.”

Research reported in this publication was supported by the National Institute on Alcohol Abuse and Alcoholism of the National Institutes of Health under Award Number R21AA029201. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.