# The Impact of Insomnia Treatment on Heavy Alcohol Use among Returning Veterans

> **NIH NIH K23** · UNIVERSITY OF MISSOURI-COLUMBIA · 2021 · $179,145

## Abstract

PROJECT SUMMARY / ABSTRACT
Heavy alcohol use is prevalent among returning Veterans and results in significant physical and psychological
burden. One in five returning Veterans screens positive for probable past-year alcohol use disorder (AUD), and
few hold positive beliefs about mental health treatment. Moreover, brief interventions for alcohol use
demonstrate limited efficacy within this population. Thus, additional strategies are needed to engage and treat
returning Veterans who may be at risk for AUD. More than half of returning Veterans who screen positive for
hazardous drinking report clinically significant symptoms of insomnia. In turn, insomnia symptoms have been
associated with increased risk of alcohol-related problems, perhaps due to insomnia-related impairments in
executive functioning, negative emotionality, craving for alcohol, and use of alcohol as a sleep aid. The
proposed K23 aims to determine the utility of the first line of treatment for insomnia (Cognitive Behavioral
Therapy for Insomnia or CBT-I) in reducing alcohol use and related problems among returning Veterans. Forty-
four returning Veterans who indicate risk for problem drinking on the Alcohol Use Disorders Identification Test
(AUDIT-C scores ≥4/5 for women/men) and have insomnia based on DSM-5 and research diagnostic criteria
will participate in a randomized pilot trial. Participants will be randomly assigned to receive personalized
normative alcohol feedback in the context of one of two treatment conditions: CBT-I (n = 22) or a time-
matched Behavioral Placebo Treatment (BPT; n = 22). Outcomes will be assessed at the end of the active
intervention period (6 weeks), mid-treatment (after 3 sessions), and at 3 months post-intervention. Outcomes
of interest include insomnia severity, total wake time, sleep quality, drinking quantity/frequency, alcohol-related
consequences, executive functioning, negative affect, emotion regulation, craving for alcohol, and use of
alcohol as a sleep aid. This research will provide Dr. Miller with mentored training in (1) the methodology of
multi-session insomnia treatment research, including daily assessment and mechanistic behavioral trial design;
(2) the interplay of sleep and alcohol use disorders; (3) assessment of executive functioning; and (4)
longitudinal mixed effects modeling. Training will take place under the mentorship of an impressive team with
complimentary areas of expertise. The proposed 5-year career development plan will facilitate Dr. Miller’s
transition to independent research by providing her the skills to (a) compete successfully for federal funding to
conduct high-quality research, (b) advance our understanding of the etiology of AUD, and (c) contribute
uniquely to alcohol addiction prevention and treatment research. The proposed research aims to reduce the
harms associated with heavy alcohol use among Veterans by improving the availability of efficacious
treatment. It will impact our understanding of the benefits of ...

## Key facts

- **NIH application ID:** 10224837
- **Project number:** 5K23AA026895-03
- **Recipient organization:** UNIVERSITY OF MISSOURI-COLUMBIA
- **Principal Investigator:** Mary Elizabeth Miller
- **Activity code:** K23 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $179,145
- **Award type:** 5
- **Project period:** 2019-07-05 → 2024-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10224837

## Citation

> US National Institutes of Health, RePORTER application 10224837, The Impact of Insomnia Treatment on Heavy Alcohol Use among Returning Veterans (5K23AA026895-03). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10224837. Licensed CC0.

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