0899 Bidirectional Links of Daily Sleep Quality and Duration with Pain in Veterans with Alcohol Use Disorder

Abstract Introduction Military Veterans tend to experience chronic pain and sleep problems of higher intensity and prevalence than the general population, and may be more likely to self-medicate with substances such as alcohol. Research suggests that sleep and pain are interrelated. However, few studies have examined bidirectional links between daily sleep quality and duration with pain among Veterans, especially those with alcohol use disorders. Furthermore, it has not been studied whether daily alcohol consumption (whether they drank or not) moderates everyday associations between sleep and pain among Veterans with alcohol use disorders. Methods 114 Veterans with alcohol use disorder (82.5% men: mean age = 38.86 [range 21–67]) completed 14 days of diaries assessing their sleep quality, sleep duration, pain, and drinking quantity. Multilevel modeling examined the effects of daily variability in sleep (within-person effects) and average levels of sleep (between-person effects) on pain the following day. To examine the effects of pain on sleep, multilevel modeling examined the effects of daily variability in pain and average levels of pain on sleep. Results Regarding bidirectional links of sleep quality and pain, greater daily (b=−.86, se=.41, p=.04) and average (b=−15.51, se=3.28, p<.001) sleep quality were associated with lower next-day pain. Higher average pain was associated with poorer sleep quality (b=−.01, se=.002, p< .001), but daily pain was not associated with daily sleep quality. Regarding bidirectional links of sleep duration and pain, there was no daily association between sleep duration and pain, but greater average sleep duration was associated with lower pain levels (b=−4.84, se=1.60, p=.003). Daily drinking did not moderate these associations. Conclusion Both sleep quality and sleep duration are closely associated with pain among Veterans with alcohol use disorder. Fluctuations of daily sleep quality affected Veterans’ pain experience in everyday life regardless of alcohol consumption; in contrast, fluctuation of daily pain did not affect daily sleep quality, implying that Veterans with alcohol use disorder are sensitive to poor sleep quality. The results support that sleep quality may buffer daily pain experiences among this patient population. Support (if any) 5K23AA026895