Effects of digital cognitive-behavioral therapy for insomnia in heavy drinkers with insomnia: A replication and extension study.

Abstract

Poor sleep and problematic drinking share a bidirectional relationship. Recent studies have targeted sleep as a novel means of improving drinking outcomes, including a prior pilot trial by our group which showed that a digital insomnia intervention (Sleep Healthy Using the Internet [SHUTi]) significantly improved sleep and drinking outcomes to a greater degree than a patient education (PE) program. In the present study, we aimed to replicate and extend our prior findings by assessing diary-derived measures of sleep and alcohol use as well as mental health outcomes in a larger sample. One hundred thirteen heavy drinkers with insomnia were randomly assigned to either the SHUTi (n = 61) or a sleep PE program (n = 52). Participants completed assessments immediately following the intervention period (9 weeks) and again at 3- and 6-months postintervention. Linear mixed-effects models showed that those in the SHUTi condition reported significantly greater improvements in sleep and greater reductions in drinking frequency relative to the PE condition. Additionally, those in the SHUTi condition reported greater reductions in depression symptoms and sleep medication use relative to the PE condition. Limitations include relatively high attrition, reliance on self-report measures, and demographic homogeneity. These findings replicate and extend the pilot trial results and support the utility of incorporating sleep interventions into alcohol use disorder prevention and treatment efforts. (PsycInfo Database Record (c) 2026 APA, all rights reserved).