# Targeting sleep homeostasis to improve alcohol use disorder treatment outcomes

> **NIH NIH R01** · UNIVERSITY OF MICHIGAN AT ANN ARBOR · 2020 · $534,150

## Abstract

ABSTRACT
Alcohol use disorder (AUD) is a leading preventable cause of morbidity and mortality in the United States.
Evidence-based treatments exist, but relapse rates among adults with AUD remain unacceptably high. Novel
approaches that target known predictors of relapse are therefore urgently needed. Insomnia during abstinence
is highly prevalent, persistent, and independently predicts relapse in adults with AUD. Pilot randomized
controlled trials by our group and others have shown that CBT for insomnia (CBTi) improves sleep and daytime
symptoms among patients with AUD and insomnia, but its impact on drinking has not been adequately tested.
Moreover, despite the identified associations between insomnia and relapse, the sleep mechanisms underlying
this relationship are poorly understood. Prior work has identified significant abnormalities in a candidate
mechanism among adults with AUD, sleep homeostasis, which is a key sleep regulatory system reflecting
“sleep drive.” The objectives of this project, therefore, are to evaluate (a) the benefits of CBTi for sleep,
drinking, and associated daytime symptoms and (b) the effects of CBTi on the homeostatic sleep system and
its association with clinical outcomes in adults in AUD treatment with insomnia. One hundred and fifty adults
entering AUD treatment at the University of Michigan Addiction Treatment Services with insomnia will be
recruited and randomized to 6 weeks of either telemedicine-delivered CBTi (CBTi-TM, n=75) or Sleep Hygiene
Education (SHE-TM, n=75). Drinking, sleep, and daytime symptom outcomes will be assessed pre- and post-
treatment and at 3-, 6- and 12-month follow-up. Objective polysomnography will be conducted before and after
treatment to assess homeostatic sleep drive. The specific aims of the study are: (1) to determine whether
CBTi-TM improves insomnia and daytime symptoms more than SHE-TM in adults in AUD treatment with
insomnia; (2) to compare the efficacy of CBTi-TM to SHE-TM on alcohol relapse; and (3) to compare the
effects of CBTi-TM to SHE-TM on homeostatic sleep drive. Secondary aims will assess the extent to which
changes in alcohol use are mediated by changes in the CBTi-TM (vs. SHE-TM) effects on the homeostatic
sleep system. The findings from this trial have important implications for the future treatment of patients with
AUD to support continued abstinence.

## Key facts

- **NIH application ID:** 10019448
- **Project number:** 5R01AA028158-02
- **Recipient organization:** UNIVERSITY OF MICHIGAN AT ANN ARBOR
- **Principal Investigator:** J. Todd Arnedt
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $534,150
- **Award type:** 5
- **Project period:** 2019-09-20 → 2024-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10019448

## Citation

> US National Institutes of Health, RePORTER application 10019448, Targeting sleep homeostasis to improve alcohol use disorder treatment outcomes (5R01AA028158-02). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10019448. Licensed CC0.

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