Drinking to Cope as a Mechanism Between Sleep Problems and Heavy Episodic Drinking Among Trauma Survivors

Objective: Women who have experienced trauma report high rates of heavy episodic drinking (HED) and sleep problems. Prior work suggests that poor sleep exacerbates heavy alcohol use; however, potential mechanisms for this association are unclear. Consistent with the self-medication model, one possibility may be that women with a history of trauma are drinking at increased rates in order to cope with the affective consequences of poor sleep. To examine this possibility, the current study tested the role of drinking to cope motives as a mediator of prospective associations between sleep problems and HED among women who have experienced trauma. Method: Community women reporting a history of trauma (N = 414, M (age) = 21.8, 59.9% White, 36.2% Black) completed self-report measures at baseline and 4 month and 8 month follow-ups. Measures of trauma exposure (Life Events Checklist [LEC]) and sleep problems (Cohen-Hoberman Inventory of Physical Symptoms-Revised [CHIPS-R]) were taken from baseline, drinking motives (Revised Drinking Motives Questionnaire) at 4 months, and HED at 8 months. Results: Findings supported an indirect association between sleep problems and later HED through increased drinking to cope motives (b = .05, 95% CI [.018, .108], beta = .05). Conclusion: As hypothesized, drinking to cope accounted for associations between sleep problems and later HED. Findings underscore the potential value in addressing drinking to cope motives as a means of reducing HED, particularly among women with a history of trauma who are sleeping poorly. Public Health Significance Statement This study indicates that high rates of heavy alcohol use among women with a history of trauma who are sleeping poorly may be driven by motivations to drink in order to cope with distress. Findings point to sleep problems and drinking to cope as potential targets to reduce heavy episodic drinking (HED) among women who have experienced trauma.