(PS1-B42) The Effects of Sleep Quality on Positive and Negative Affect, Alcohol Use, and Cravings: An Ecological Momentary Study of Depressed Young Adults

Sleep quality is negatively associated with both craving and frequency of use in numerous substances including alcohol. Despite the robust relationship, the precise mechanisms by which sleep impacts craving and use remain unclear, though affective states are likely to play a role. Previous ambulatory evidence has suggested that better sleep quality is linked to subsequent increased positive affect and decreased negative affect, and better affect being linked to improved sleep quality. Affective functioning figures prominently in many etiological models of substance use. However, associations between affect and substance use are complex and prior research in this area indicates mixed and conflicting results. One way to clarify these mixed findings is to examine factors that contribute to variation in positive and negative affect across time and people that also has direct implications on substance use, such as sleep. The current study aims to fill these important gaps in the literature in a sample of young adults where sleep, affect, and substance use related concerns are likely to be salient, namely currently depressed college students that exhibit regular substance use. In a two-week EMA study, regular drinking young college students (N=93 participants) who met the criteria for depression at baseline, assessed with the PROMIS Emotional Distress–Depression–Short Form, completed regular daily and random momentary assessments of affective states and alcohol use (observations=1,354). Multilevel structural equation modeling analyses showed that there was a positive association with sleep quality and positive affect at both the within-person (β=.083, p=.016) and between-person levels (β=.465, p=.002). Associations with sleep quality and negative affect at both the within-person and between-person levels were not significant. Further, at the within-person level, negative affect was positively associated with craving (β=.108, p< .001), and at the between-person level, positive affect (β=.227, p=.015) and negative affect (β=.216, p=.022) were positively associated with craving. Additionally, the indirect effect of positive affect on craving through sleep quality was found to be significant (β=.151, p=.017). These findings highlight the understudied yet significant temporal associations between sleep quality, affect, and substance cravings. Broader implications include implementing these findings in a clinical setting to improve addiction treatment outcomes with personalized interventions specific to individuals and their daily functioning. Specifically, results from this line of research may inform harm reduction or prevention efforts by targeting sleep quality or sleep disturbance to ameliorate craving in individuals seeking to reduce their alcohol use.