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• Sleep disturbance was associated with greater volumes in the lateral ventricles and greater total white matter hyperintensities. • Sleep disturbance was associated with lower mean volumes in 12 hippocampal, frontal, parietal, and temporal lobe regions. • Males, Hispanic participants, and those with less formal education were more likely to report sleep disruption. • A dementia diagnosis moderated the relationship between sleep disturbance and right and left lateral ventricular volumes. This study aimed to 1) determine the association between sleep disturbance and brain structure volumes, 2) the moderation effect of apolipoprotein ε4 genotype on sleep disturbance and brain structures, and 3) the moderation effect of sleep disturbance on cognitive status and regional brain volumes. Using the National Alzheimer's Coordinating Center Uniform Data Set (n = 1,533), multiple linear regressions were used to evaluate the association between sleep disturbance and brain volumes. Sleep disturbance was measured using one question from the NPI-Q. After controlling for intracranial volume, age, sex, years of education, race, ethnicity, and applying the FDR correction, total cerebrospinal fluid volume, left lateral ventricle volume, total lateral ventricle volume, and total third ventricle volume demonstrated significantly higher means for those with sleep disturbance. Total brain volume, total white and gray matter volume, total cerebrum brain volume (including gray but not white matter), left hippocampus volume, total hippocampal volume, the left, right, and total frontal lobe cortical gray matter volume, and the left, right, and total temporal lobe cortical gray matter volume demonstrated significantly lower mean volumes for those with sleep disturbance. Sleep disturbance moderated the association between cognitive status and lateral ventricular volumes. These findings suggest that disrupted sleep is associated with atrophy across multiple brain regions and ventricular hydrocephalus ex vacuo. [ABSTRACT FROM AUTHOR]

Objectives: Many studies have investigated the role that travel plays in athletic performance. However, these studies lacked a holistic representation of travel. For instance, they do not consider travel distance and uniquely focuses on travel direction.Design: An open source (www.evolving-hockey.com) provided NHL (2013-2020) game data. In total, this resulted in 17,088 regular season games.Methods: Linear and quadratic versions of time zone change (TZΔ) and adjusted jet lag (AJL) were formulated. TZΔ captured circadian delay/advance based on travel for a game, with each TZ going eastward and westward reflected by -1 and +1, respectively. AJL advances TZΔ by allowing TZ acclimation, with each day resulting in a 1-unit change towards circadian neutral. AJL is a season-long rolling summation, which was computed using two different travel approaches: Approach A (AJL_A) assumes travel the day before each game, whereas Approach B (AJL_B) was designed to prioritize being home. A standardized flight tracker determined travel distance for each game. Team ability differences, characterized as difference in total season points, served as an analytic covariate. Outcome variables included goal differential, difference between actual and expected Fenwick save percentage (dFSv%), and goals saved above average (GSAA).Results: GameDistance (β = -0.14, p = 0.0007), AJL_B2 (β = -0.15, p = 0.0006), and their interaction (p = 0.0004) associated with GoalDifferential. GameDistance (β = -0.18, p = 0.02) and AJL_B2 (β = 0.12, p = 0.03) associated with dFSv%, whereas only AJL_B2 (β = 0.03, p = 0.05) associated with GSAA.Conclusions: Results suggest that circadian change, in both direction, and greater traveled distance can negatively impact NHL athletes. [ABSTRACT FROM AUTHOR]

Introduction: Inadequate sleep (≤6 and ≥9h) is more prevalent in smokers than non-smokers but the extent to which sleep duration in smokers relates to smoking behaviors and cessation outcomes, is not yet clear. To begin to address this knowledge gap, we investigated the extent to which sleep duration predicted smoking behaviors and quitting intention in a population sample.Methods: Data from current smokers who completed the baseline (N=635) and 5-year follow-up (N=477) assessment in the United Kingdom Biobank cohort study were analyzed. Multivariable regression models using smoking behavior outcomes (cigarettes per day, time to first cigarette, difficulty not smoking for a day, quitting intention) and sleep duration (adequate (7-8h) versus inadequate (≤6 and ≥9h) as the predictor were generated. All models adjusted for age, sex, race, and education.Results: Worsening sleep duration (adequate to inadequate) predicted a more than three-fold higher odds in increased cigarettes per day (OR=3.18; 95% CI=1.25-8.06), a more than three-fold increased odds of not smoking for the day remaining difficult (OR=3.90; 95% CI=1.27-12.01), and a >8-fold increased odds of higher nicotine dependence (OR=8.98; 95% CI=2.81-28.66). Improving sleep duration (i.e., inadequate to adequate sleep) did not predict reduced cigarette consumption or nicotine dependence in this population sample.Conclusion: Transitioning from adequate to inadequate sleep duration may be a risk factor for developing a more "hard-core" smoking profile. The extent to which achieving healthy sleep may promote, or optimize smoking cessation treatment response, warrants investigation. [ABSTRACT FROM AUTHOR]

Suicide is the second leading cause of death, worldwide, for those between the ages of 24 and 44 y old. In 2013, more than 41,000 suicides occurred in the United States. These statistics underscore the need to 1) understand why people die by suicide and 2) identify risk factors that are potentially modifiable. While it has been posited that sleep disturbance may represent one such factor, systematic research in this arena did not begin until the 2000s. Since that time, sleep disturbance has been reliably identified as a risk factor for suicidal ideation, suicide attempts, and suicide. While insomnia, nightmares, and other sleep disorders have each been found to contribute to the risk for suicidal ideation and behavior, it is also possible that these factors share some common variance. One possibility is that sleep disturbance results in being awake at night, and being awake at night also confers risk. The hypothesis proffered here is that being awake when one is not biologically prepared to be so results in "hypofrontality" and diminished executive function, and that this represents a common pathway to suicidal ideation and behavior. Such a proposition is highly testable under a variety of possible protocols. The current review summarizes the extant literature on suicide rates by time-of-day, and discusses circadian, psychosocial, and neurocognitive explanations of risk. Such a focus promises to enhance our understanding of how sleep disturbance may confer risk, allows for the identification of future lines of research, and further justifies the need for interventions that promote good sleep continuity among at-risk individuals. [ABSTRACT FROM AUTHOR]

Digital media use is widespread in University students, and use of digital media near bedtime has a broadly negative effect on sleep outcomes. Adequate and good quality sleep is important for physical and mental health, but few studies have rigorously measured both sleep and digital media use. In this study, we investigated whether self-reported sleep patterns were associated with digital media use in a first-year University student (N = 254, 48% male) population. Students tracked their sleep through daily online diaries and provided digital media use data in 15-min blocks for 2 h prior to bedtime on nine occasions. A longer duration of digital media use was associated with reduced total sleep time and later bedtime, while greater diversity of digital media use was associated with increased total sleep time and earlier bedtime. Analysis of activities in the last hour before bedtime indicated that activity type plays a role in digital media's effect on sleep, with computer work, surfing the Internet, and listening to music showing the strongest relationship to multiple sleep variables. These findings have implications for physical and mental health of University students and can inform design of devices to minimize negative effects of digital media on sleep. [ABSTRACT FROM AUTHOR]

The majority of sleep research has focused on deleterious health outcomes, with little attention to positive sequels. A systematic review of the literature regarding sleep duration and/or sleep quality in relation to mental toughness and resilience amongst non-clinical, healthy populations was completed. Eight databases and selected sources for grey literature were searched from their inception to April 2021. A total of 1925 unique records (1898 from the database search and 27 from grey sources) were identified and screened against the pre-set inclusion and exclusion criteria. Of these, 68 studies were eligible and 63 were included in the meta-analysis. Pooled results indicated a weak, positive correlation between sleep duration and resilience (r = 0.11, p < 0.001), and sleep quality (r = 0.27, p < 0.001). The pooled correlation was slightly attenuated for prospective studies pertaining to sleep quality and resilience (r = 0.18, p < 0.001). We found evidence of high publication bias for studies that explored the relationship between sleep quality and resilience. Sleep and resilience are positively correlated but additional research is needed to verify the direct relationship through carefully designed, prospective studies that capture both subjective and objective sleep estimates. For a more comprehensive understanding, complementary reviews that explore the sleep-resilience association are needed for clinical populations, and those who have suffered extreme hardship. [ABSTRACT FROM AUTHOR]

Background Preliminary evidence suggests sleep medications are associated with risk of vascular events; however, the long-term vascular consequences are understudied. This study investigated the relation between sleep medication use and incident stroke. Methods Within the REasons for Geographic And Racial Differences in Stroke study, 21,678 black participants and white participants (≥45 years) with no history of stroke were studied. Participants were recruited from 2003 to 2007. From 2008 to 2010, participants self reported their prescription and over-the-counter sleep medication use over the past month. Suspected stroke events were identified by telephone contact at 6-month intervals and associated medical records were retrieved and physician-adjudicated. Proportional hazards analysis was used to estimate hazard ratios for incident stroke associated with sleep medication use (0, 1-14, and 15+ days per month) controlling for sociodemographics, stroke risk factors, mental health symptoms, and sleep apnea risk. Results At the sleep assessment, 9.6% of the sample used prescription sleep medication and 11.1% used over-the-counter sleep aids. Over an average follow-up of 3.3 ± 1.0 years, 297 stroke events occurred. Over-the-counter sleep medication use was associated with increased risk of incident stroke in a frequency-response relationship ( P = .014), with a 46% increased risk for 1-14 days of use per month (hazards ratio [HR] = 1.46; 95% confidence interval [CI], .99-2.15) and a 65% increased risk for 15+ days (HR = 1.65; 95% CI, .96-2.85). There was no significant association with prescription sleep medications ( P = .80). Conclusions Over-the-counter sleep medication use may independently increase the risk of stroke beyond other risk factors in middle-aged to older individuals with no history of stroke. [ABSTRACT FROM AUTHOR]

Abstract: Objective: The aim of this investigation was to assess the relationships between suicidal ideation and insomnia symptoms in Veterans misusing alcohol. Method: Data were extracted in this retrospective chart review of Veterans referred from primary care for a behavioral health evaluation (N=161) based on evidence of heavy drinking, drug use or another behavioral problem. Suicidal ideation (SI) was assessed using the Paykel questionnaire. Insomnia symptoms were assessed with standard diary questions in an interview format and pertained to sleep latency (SL), wake after sleep onset time (WASO), sleep quality (SQ), and habitual sleep duration (HSD). The relations between suicidal ideation and insomnia symptoms were assessed using ordinal regression analyses adjusted for socio-demographic, psychiatric and addiction-related variables. Results: Suicidal ideation was reported in 62 (39%) of the Veterans interviewed. In a multivariable model, only inadequate SQ was associated with suicidal ideation. Short sleepers were more likely to endorse suicidal ideation and have attempted suicide in the past year. In addition, older age, inadequate financial status, and the presence of a psychiatric disorder were also significantly associated with suicidal ideation in most of the adjusted models. Conclusion: Given their association with suicidal ideation, insomnia symptoms in Veterans misusing alcohol should prompt an assessment of underlying psychiatric and social factors. [Copyright &y& Elsevier]

Summary: Over 20 years of evidence indicates a strong association between obstructive sleep apnea (OSA) and cardiovascular disease. Although inflammatory processes have been heavily implicated as an important link between the two, the mechanism for this has not been conclusively established. Atherosclerosis may be one of the mechanisms linking OSA to cardiovascular morbidity. This review addresses the role of circulating adhesion molecules in patients with OSA, and how these may be part of the link between cardiovascular disease and OSA. There is evidence for the role of adhesion molecules in cardiovascular disease risk. Some studies, albeit with small sample sizes, also show higher levels of adhesion molecules in patients with OSA compared to controls. There are also studies that show that levels of adhesion molecules diminish with continuous positive airway pressure therapy. Limitations of these studies include small sample sizes, cross-sectional sampling, and inconsistent control for confounding variables known to influence adhesion molecule levels. There are potential novel therapies to reduce circulating adhesion molecules in patients with OSA to diminish cardiovascular disease. Understanding the role of cell adhesion molecules generated in OSA will help elucidate one mechanistic link to cardiovascular disease in patients with OSA. [Copyright &y& Elsevier]

Highlights: [•] Overall, more drowsy driving in short sleepers and less in long sleepers. [•] With 7 nights/wk insufficient sleep, more drowsy driving in both short and long sleepers. [•] With 0 nights/wk insufficient sleep, more drowsy driving in short sleepers. [•] Short sleepers at greater risk of drowsy driving, irrespective of sufficient sleep. [ABSTRACT FROM AUTHOR]

Summary: Existing data from laboratory studies suggest a number of negative consequences of acute reductions in sleep time. Also, epidemiological data suggest links between shorter self-reported sleep duration and negative health outcomes. These bodies of work are growing, revealing several key points of convergence and opportunities for future exploration. In addition, they begin to highlight possible problems experienced by “short sleepers,” who sleep approximately 6h or less per night. While it is likely that this group is heterogeneous, comprised both of individuals with less need for sleep and those not sleeping enough, the laboratory and epidemiological findings point towards directions that can be more fully explored in verified short sleepers. This paper discusses problems associated with the terminology used to describe “short sleep,” summarizes laboratory studies exploring neurobehavioral performance, metabolism and obesity, and psychological health and epidemiological studies exploring mortality risk, obesity and metabolism, cardiovascular disease, and general health/psychosocial stress, describes studies of verified short sleepers and explores areas of convergence, laying out possible future directions. [Copyright &y& Elsevier]

Summary: This review of the scientific literature examines the widely observed relationship between sleep duration and mortality. As early as 1964, data have shown that 7-h sleepers experience the lowest risks for all-cause mortality, whereas those at the shortest and longest sleep durations have significantly higher mortality risks. Numerous follow-up studies from around the world (e.g., Japan, Israel, Sweden, Finland, the United Kingdom) show similar relationships. We discuss possible mechanisms, including cardiovascular disease, obesity, physiologic stress, immunity, and socioeconomic status. We put forth a social–ecological framework to explore five possible pathways for the relationship between sleep duration and mortality, and we conclude with a four-point agenda for future research. [Copyright &y& Elsevier]

Summary: While much is known about the negative health implications of insufficient sleep, relatively little is known about risks associated with excessive sleep. However, epidemiological studies have repeatedly found a mortality risk associated with reported habitual long sleep. This paper will summarize and describe the numerous studies demonstrating increased mortality risk associated with long sleep. Although these studies establish a mortality link, they do not sufficiently explain why such a relationship might occur. Possible mechanisms for this relationship will be proposed and described, including (1) sleep fragmentation, (2) fatigue, (3) immune function, (4) photoperiodic abnormalities, (5) lack of challenge, (6) depression, or (7) underlying disease process such as (a) sleep apnea, (b) heart disease, or (c) failing health. Following this, we will take a step back and carefully consider all of the historical and current literature regarding long sleep, to determine whether the scientific evidence supports these proposed mechanisms and ascertain what future research directions may clarify or test these hypotheses regarding the relationship between long sleep and mortality. [Copyright &y& Elsevier]

Abstract: While there are data supporting the use of light in clinical populations, there has been less investigation of relationships among light and psychological variables in non-clinical samples. Subjects were 459 ethnically diverse women (mean age 67.68) recruited as part of the Women''s Health Initiative. Light exposure and sleep were measured with an Actillume wrist actigraph. Subjects completed questionnaires, investigating Social Support, Social Functioning, Social Strain, Quality of Life, Satisfaction with Life, Emotional Well-being, Optimism, Negative Emotional Expressiveness, and Role Limitation Due to Emotional Problems. Significant partial correlations (controlling for age, education and ethnicity) were found between mesor light exposure and Social Functioning, Quality of Life, Satisfaction with Life, and Emotional Well-Being. Quality of Life and Satisfaction with Life were also found to be significantly correlated with morning light. The most parsimonious model to account for the variance shared between mesor light and the predictors included only Quality of Life. The variance shared between mesor light exposure and social and emotional functioning could be subsumed under the variance shared between mesor light exposure and Quality of Life. Increased light exposure is related to improved quality of life and social and emotional functioning. [Copyright &y& Elsevier]

Insomnia is associated with suicide risk in civilian and military populations. Thwarted belongingness is proposed as a mediator of this relationship under the Interpersonal Theory of Suicide (IPTS). The present study explored how insomnia relates to suicidal ideation in conjunction with thwarted belongingness among civilians, Service members, and Veterans. Methods. Data from the Military Suicide Research Consortium for N = 6556 individuals (6316 with non-missing suicidal ideation status) were divided into 4 subgroups: civilians, never deployed Service members, previously deployed Service members, and Veterans. Robust Poisson models evaluated the associations between insomnia severity/subtype and current suicidal ideation, with bootstrap mediation models assessing thwarted belongingness as a mediator. Results. A 5-point increase in insomnia severity was associated with a 38% increased risk for current suicidal ideation among civilians, a 56% greater risk among never deployed Service members, an 83% greater risk among previously deployed Service members, and a 37% greater risk among Veterans. Moreover, active Service members showed greater associations between difficulty falling asleep and staying asleep with suicidal ideation than civilians. These associations were independent of covariates and only mediated by thwarted belongingness among Veterans. Conclusions. The relationship between insomnia and suicide is not purely explained by thwarted belongingness except among Veterans. Future research should explore additional psychological and neurobiological mechanisms connecting insomnia and suicidality. [ABSTRACT FROM AUTHOR]

To examine retrospectively whether access to a campus food pantry (CFP) is related to improvements in sleep, mental health, and physical health among college students in a public university system. Retrospective, cross-sectional study of student CFP users who completed an online survey in the summer of 2019. Ten-campus University of California system. A total of 1,855 students completed the survey. Students reported the number of CFP visits in a usual week or month. Students retrospectively rated their perceived health, depressive symptoms, and sleep sufficiency before and after having food pantry access. The difference between pre- and post-food pantry access responses was calculated. Path analysis was used to examine direct and indirect paths of the relationship between CFP visits with self-reported changes in depressive symptoms and perceived health through positive changes in self-reported sleep sufficiency, controlling for sociodemographic factors. More monthly CFP visits were directly related to decreased depressive symptoms and improved perceived health (β depressive = 0.10, P < 0.001; β health = 0.12, P < 0.001). In addition, more CFP visits were related to improved sleep sufficiency (β = 0.09, P = 0.001), which in turn was related to a decrease in depressive symptoms (β = 0.24, P = 0.001; indirect effect: 0.02, P < 0.01) and improved perceived health (β = 0.23, P < 0.001; indirect effect: 0.02, P < 0.01). Findings suggest that college campus emergency food access is associated with self-reported improvements in student health outcomes associated with food security. Until more long-term solutions that improve college student nutrition are developed, food pantries may be filling a gap. [ABSTRACT FROM AUTHOR]

Military personnel rely on caffeinated products such as coffee or energy drinks (ED) to maintain a maximal level of vigilance and performance under sleep-deprived and combat situations. While chronic caffeine intake is associated with decreased sleep duration and non-restful sleep in the general population, these relationships are relatively unclear in the military personnel. We conducted a focused review of the effects of caffeinated products on sleep and the functioning of military personnel. We used a pre-specified search algorithm and identified 28 peer-reviewed articles published between January 1967 and July 2019 involving military personnel. We classified the findings from these studies into three categories. These categories included descriptive studies of caffeine use, studies evaluating the association between caffeinated products and sleep or functioning measures, and clinical trials assessing the effects of caffeinated products on functioning in sleep-deprived conditions. Most of the studies showed that military personnel used at least one caffeine-containing product per day during active duty and coffee was their primary source of caffeine. Their mean caffeine consumption varied from 212 to 285 mg/day, depending on the type of personnel and their deployment status. Those who were younger than 30 years of age preferred ED use. Caffeine use in increasing amounts was associated with decreased sleep duration and increased psychiatric symptoms. The consumption of caffeinated products during sleep deprivation improved their cognitive and behavioral outcomes and physical performance. Caffeine and energy drink consumption may maintain some aspects of performance stemming from insufficient sleep in deployed personnel, but excessive use may have adverse consequences. • Military personnel reported a mean daily consumption of 212-285mg/day • Coffee was the primary caffeine source for military personnel over the age of 25 years and Energy Drinks for younger staff • Energy Drink (ED) use was associated with sleep disturbances • Caffeine/ED use had beneficial effects on performance after prolonged sleep deprivation [ABSTRACT FROM AUTHOR]

• Meta-analysis of light and circadian phase-shifting across studies conducted from 1964 to 2017. • Experiments in rodents were not diverse for several (important) biological variables. • Circadian responses to stationary broadspectrum light scaled with time-integrated illuminance. We conducted a meta-analysis of papers published over the past half-century (1964–2017) that quantified the phase-shifting effects of timed light exposure on rodent locomotor rhythms. Descriptive statistics were tabulated in order to explore the extent to which these studies were generalizable across species, sex, age, circadian timing, and light sources. Attempts at understanding photic resetting were primarily targeted at younger male animals, with particular emphases placed on characterizing the pacemaker systems of C57BL/6 mice and Syrian hamsters during the parts of their subjective night most sensitive to delivery of white-fluorescent light. With subsequent analyses restricted to these rodent models, we then assessed the relationship between luminous exposure (via broadspectrum emission) and phase-shifting through a series of linear regressions. Monotonically increasing illuminance-response functions were noted at most circadian times surveyed. In the aggregate, our results show that previous research conducted on light's regulation of circadian timekeeping has been skewed in design with respect to several important biological variables. This bias might limit translation of phototherapy-relevant data to women and older individuals. [ABSTRACT FROM AUTHOR]

Objective: Sleep, which plays an important role in health and well-being, is socially patterned such that certain demographic groups have worse sleep health than others. One possible mechanism driving sleep disparities is social capital. The current study examines the association between social capital and self-reported sleep variables (eg, duration, insomnia symptoms, and daytime sleepiness) among a sample of 1007 participants from the Sleep Health and Activity, Diet and Environment Study (SHADES).Methods: Logistic regressions were used to estimate whether the sleep variables were associated with social capital measures. All models control for age, sex, race/ethnicity (Non-Hispanic White, Black/African-American, Hispanic/Latino, Asian, and multicultural/other), income, and education (less than high school, high school graduate, some college, and college graduate).Results: Lower likelihood of membership in groups was seen for long sleepers (>9hrs, p-value<0.05) and beliefs that neighbors rarely/never help each other was more likely among short sleepers (5-6hrs, p-value<0.05), relative to 7-8 h sleepers. A decreased sense of belonging was seen among short sleepers (5-6hrs, p-value<0.05). Decreased likelihood of trust was reported by those with moderate-severe insomnia (p-value<0.05). Similarly, neighborhood improvement efforts were less likely among individuals with moderate-to-severe insomnia (p-value<0.05).Conclusions: Results of our study show that short and long sleep duration, as well as insomnia, were inversely related to measures of social capital, such as group memberships and a sense of neighborhood belonging. Future research may explore the directionality of the relationship between social capital and sleep and perhaps consider future interventions to improve low social capital and/or poor sleep in community samples. [ABSTRACT FROM AUTHOR]

Objective/background: Poor quality and inadequate sleep are associated with impaired cognitive, motor, and behavioral components of sport performance and increased injury risk. While prior work identifies sports-related concussions as predisposing factors for poor sleep, the role of sleep as a sports-related concussion risk factor is unknown. The purpose of this study was to quantify the effect of poor sleep quality and insomnia symptoms on future sports-related concussion risk.Patients/methods: In this study, 190 NCAA Division-1 athletes completed a survey battery, including the Insomnia Severity Index (ISI) and National Health and Nutrition Examination Survey (NHANES) Sleep module. Univariate risk ratios for future sports-related concussions were computed with ISI and NHANES sleepiness scores as independent predictors. An additional multiple logistic regression model including sport, sports-related concussion history, and significant univariate predictors jointly assessed the odds of sustaining a concussion.Results: Clinically moderate-to-severe insomnia severity (RR = 3.13, 95% CI: 1.320-7.424, p = 0.015) and excessive daytime sleepiness two or more times per month (RR = 2.856, 95% CI: 0.681-11.977, p = 0.037) increased concussion risk. These variables remained significant and comparable in magnitude in a multivariate model adjusted for sport participation.Conclusion: Insomnia and daytime sleepiness are independently associated with increased sports-related concussion risk. More completely identifying bidirectional relationships between concussions and sleep requires further research. Clinicians and athletes should be cognizant of this relationship and take proactive measures - including assessing and treating sleep-disordered breathing, limiting insomnia risk factors, improving sleep hygiene, and developing daytime sleepiness management strategies - to reduce sports-related concussion risk and support overall athletic performance. [ABSTRACT FROM AUTHOR]

Introduction Although psychosocial problems are commonly associated with both alcohol misuse and insomnia, very little is known about the combined effects of insomnia and current alcohol dependence on the severity of psychosocial problems. The present study evaluates whether the co-occurrence of insomnia and alcohol dependence is associated with greater psychosocial problem severity. Methods Alcohol dependent individuals (N = 123) were evaluated prior to participation in a placebo-controlled medication trial. The Short Index of Problems (SIP), Addiction Severity Index (ASI), Insomnia Severity Index (ISI), and Time Line Follow Back (TLFB), were used to assess psychosocial, employment, and legal problems; insomnia symptoms; and alcohol consumption, respectively. Bivariate and multivariate analyses were used to evaluate the relations between insomnia and psychosocial problems. Results Subjects' mean age was 44 years (SD = 10.3), 83% were male, and their SIP sub-scale scores approximated the median for normative data. A quarter of subjects reported no insomnia; 29% reported mild insomnia; and 45% reported moderate-severe insomnia. The insomnia groups did not differ on alcohol consumption measures. The ISI total score was associated with the SIP total scale score (β = 0.23, p = 0.008). Subjects with moderate–severe insomnia had significantly higher scores on the SIP total score, and on the social and impulse control sub-scales, and more ASI employment problems and conflicts with their spouses than others on the ASI. Conclusion In treatment-seeking alcohol dependent subjects, insomnia may increase alcohol-related adverse psychosocial consequences. Longitudinal studies are needed to clarify the relations between insomnia and psychosocial problems in these subjects. [ABSTRACT FROM AUTHOR]