Diverting the Pathway to Substance Misuse by Improving Sleep.

摘要

The recent Institute of Medicine report underscores an alarming increase in alcohol and other substance misuse among military personnel. Such problems will likely increase after leaving active duty. Sleep disturbances are very common among Warfighters with recent deployments and are associated with mental health problems and alcohol and other substance misuse. Insomnia is highly intertwined with alcohol and substance use disorders and has been found to motivate continuing and incident misuse. The over-arching premise for this proposal is that targeting sleep disturbance in post-deployed Veterans in a manner that addresses factors that are specific to military service, will reduce and prevent the progression of the common misuse of alcohol and other substances. The goal for this R34 proposal is to develop and test an intervention of which the primary target is disturbed sleep. The intervention will incorporate established sleep behavioral interventions, and include a novel component designed to address nocturnal vigilance, a prominent feature of post deployment sleep interference. We will also assess overall alcohol and drug use in the target population, its relationship with sleep disturbance; include an educational/motivational module addressing substance use and sleep. We will assess the effect of participation on substance use and the degree to which the effect is accounted for by improvements in sleep.