Sleep dysregulation in alcohol use disorders. An exploratory study with a gender perspective.

Background: Chronic alcohol consumption alters sleep architecture. The alteration persists during early abstinence. Sleep dysregulation is one of the most common complaints of people with alcohol use disorder. The prevalence of insomnia in individuals with alcohol use disorders shows high variability (31%-91%) attributable to the diagnostic procedure used to identify insomnia (Wołyńczyk-Gmaj et al, 2022). It is a risk factor for relapse and maintains a bidirectional relationship with mood dysregulation and other socio-familial, socio-occupational and interpersonal repercussions. Only one work has been identified in the literature that explores insomnia from the perspective of binary gender (Inkelis et al, 2020). In this work, data obtained from clinical experience are explored in order to identify insomnia symptoms that allow individualizing interventions and with a gender perspective.
 Methods: The results of the data obtained at the Addictive Behavior Unit (UCA) of the Clinical Hospital of Barcelona are presented. They were obtained during the months of February to April 2024. In addition to the sociodemographic data, the questionnaire developed by the WHO was used to identify alcohol use disorders, the AUDIT (Bador, 2011), where the higher score increased risk of presenting an alcohol use disorder, and a self-report instrument has also been used, and the insomnia severity index, ISI, in its validation in Spanish (Fernández-Mendoza et al, 2012). The inclusion of users was carried out incidentally, with participants providing consent to participate and being carried out anonymously.
 Results: A total of 22 patients were included, of which 11 men and 11 women. 8 women (73%) and 6 men (54%) met criteria for an alcohol use disorder, with a mean AUDIT score in women of 22.82 (Standard Deviation 9.30) and a mean AUDIT score in men of 21.55 (Standard Deviation 10.45). When considering the scores on the ISI, women obtained an average score of 13.36 (with a standard deviation of 7.10), and men obtained an average score of 12.82 and a standard deviation of 7.6. 5 women obtained ISI scores suggestive of severe or moderate insomnia (45%), with no differences observed when we compared the 5 men with scores suggestive of severe or moderate insomnia (45%). 
Conclusions: The results obtained are partially consistent with those reported in the reviewed literature. It would be necessary to increase the case mix to obtain greater statistical power. The use of methodologies not based solely on self-reports would also be required. We ally ourselves with the authors who consider that insomnia is a symptom that interferes with the maintenance of abstinence and that requires comprehensive biopsychosocial treatment. Finally, we emphasize the need to study it from a gender perspective, both binary and transgender or diverse genders.