Is there a 24-hour rhythm in alcohol craving and does it vary by sleep/circadian timing?

ABSTRACT

Increasing evidence implicates sleep/circadian factors in alcohol use; however, the role of such factors in alcohol craving has received scant attention. Prior research suggests a 24-hour rhythm in related processes (e.g., reward motivation), but more research directly investigating a rhythm in craving is needed. Moreover, prior evidence is ambiguous whether such a rhythm in alcohol craving may vary by sleep/circadian timing. To examine these possibilities, 36 late adolescents (18–22 years of age; 61% female) with regular alcohol use but without a current alcohol use disorder were recruited to complete smartphone reports of alcohol craving intensity six times a day for two weeks. During these two weeks, participants wore wrist actigraphs and completed two in-lab assessments (on Thursday and Sunday) of dim light melatonin onset (DLMO). Average actigraphically derived midpoint of sleep on weekends and average DLMO were used as indicators of sleep and circadian timing, respectively. Multilevel cosinor analysis revealed a 24-hour rhythm in alcohol craving. Findings across the sleep and circadian timing variables converged to suggest that sleep/circadian timing moderated the 24-hour rhythm in alcohol craving. Specifically, people with later sleep/circadian timing had later timing of peak alcohol craving. These findings add to the growing evidence of potential circadian influences on reward-related phenomena and suggest that greater consideration of sleep and circadian influences on alcohol craving may be useful for understanding alcohol use patterns and advancing related interventions.

Keywords:

• Alcohol
• alcohol craving
• diurnal rhythm
• circadian rhythm
• dim light melatonin onset
• actigraphy
• midpoint of sleep
• ecological momentary assessment
• chronotype

Acknowledgements

We would like to thank the Office of Academic Computing in the Department of Psychiatry at the University of Pittsburgh School of Medicine for developing the online EMA assessment system used in this study.

Declaration of Interest

The authors report no conflicts of interest.

Notes

1. Given the low-response rate for alcohol craving, we also analyzed core study hypotheses using a binary alcohol craving outcome variable. Findings were consistent with results when using the continuous alcohol craving variable, i.e., coefficients from models were in the same direction and had the same pattern of statistical significance.

2. As a thoughtful reviewer suggested, there may be other rhythms occurring in the data. Thus, we also explored whether 8 or 12 h rhythms may explain alcohol craving patterns; however, the results of the additional models suggested that a model with just the 24 h sine and cosine terms most parsimoniously described the data.

Additional information

Funding

This work was supported by the National Institute on Alcohol Abuse and Alcoholism [R21 AA023209]; National Institute on Drug Abuse [K01 DA032557, R01DA044143].