Mechanisms of Risky Alcohol Use in Young Adults: Linking Sleep Duration and Timing to Reward- and Stress-Related Brain Function

7. PROJECT SUMMARY/ABSTRACT
The long-term objectives of this proposal are: 1) to evaluate a biobehavioral model of alcohol use disorder
(AUD) in young adults with recent high-risk drinking (≥ 4 drinks/day or ≥ 8/week for women, ≥ 5 drinks/day or ≥
15/week for men) and high lifetime exposure to stressors, and 2) to leverage sleep and circadian function to
promote mental health. These objectives are consistent with two key priorities of the National Institute of
Alcohol Abuse and Alcoholism (NIAAA): 1) identify mechanisms of AUDs, and 2) improve prevention and
treatment for alcohol misuse. The proposed model of AUD posits that sleep duration and/or timing moderate
the effects of stressful life events on high-risk alcohol use by disrupting reward- and stress-related brain
function. The research approach uses two complementary study designs to evaluate the proposed model: 1)
an observational study (n=150) that will assess the degree to which short and late sleep predict later reward-
and stress-related brain function and alcohol use, and 2) an experimental study (n=100) that will evaluate the
extent to which sleep duration and timing affect reward- and stress-related brain function and alcohol use. The
sample includes young adults (18-24 years of age) with recent high-risk drinking and high lifetime exposure to
stressors (≥20 stressors on a lifetime stress and adversity inventory). Recruitment will be stratified to include
young adults with short and late sleep (weekday sleep duration ≤ 6 h & midpoint ≥ 4 am; n=100) versus long
and early sleep (weekday sleep duration ≥ 8h & midpoint ≤ 2:30 am; n=50). Both studies include measurement
of daily sleep and stressful events for 2 weeks; subsequent laboratory measures of reward- and stress-related
brain function and sleep and circadian characteristics; and self-report measures of alcohol use during daily
monitoring and 2-month follow-up. The experimental study includes random assignment of young adults with
short and late sleep from the observational study to 2 weeks of either: 1) 90 min extension and advance of
sleep opportunity and timing (n=50); or 2) typical sleep opportunity and timing (n=50). This research approach
will accomplish three specific aims: 1) Evaluate the extent to which sleep duration and/or timing predict reward-
and stress-related brain function, and moderate the effects of stressful life events; 2) Establish the extent to
which sleep duration and/or timing affect reward- and stress-related brain function, and moderate the effects of
stressful life events; and 3) Determine the extent to which changes in reward- or stress-related brain function
mediate the associations between sleep duration and/or timing and alcohol use. The investigative team has
expertise in the etiology and prevention of AUD in young adults, including specific expertise in the impact of
sleep and stressful life events on the stress and reward systems that contribute to AUD. All three investigators
are also licensed psychologists who are committed to translating research on the mechanisms of
psychopathology to preventative interventions.

Grant Number: 5R01AA029125-05
NIH Institute/Center: NIH
Principal Investigator: Melynda Casement