Young adulthood is the best period to nip alcohol use issues in the bud, but convincing young people to take problematic drinking behavior seriously is a challenge. New Yale research has found an innovative way to engage this cohort.
The key, researchers discovered, is pointing out the detrimental effect of alcohol on sleep health while providing counseling to help young people make healthy changes. In the study, researchers recruited 120 subjects between the ages of 18 and 25 who reported heavy drinking and sleep concerns. Researchers recruited participant from communities across Connecticut.
"These have never been used in a treatment context where you give someone feedback about alcohol content or the effects of alcohol," said lead author Lisa Fucito, an associate professor of psychiatry at Yale School of Medicine (YSM). "We put an additional spin on it - along with feedback about drinking, we incorporated feedback about sleep and showed how the two go together."
For two weeks, subjects wore biosensors that monitored both alcohol use and sleep health. Data from the biosensors, along with personalized coaching, helped young adults cut back on risky drinking behavior and improve their sleep.
The study, published in JAMA Open Network, marks the first time that biosensors - in this case, devices attached to the wrist or ankle - have been used to monitor alcohol use along with other biometrics in an integrated way, Fucito said.
"The onset rates of heavy drinking and alcohol use disorder peak during young adulthood," Fucito said. "It's a risky time for developing a lifelong alcohol problem."
The sticking point is that the group most at risk for developing a drinking problem are also the group least likely to seek help. To reach young people, researchers targeted other issues this demographic cares about. Focus group research and other surveys revealed that young people are concerned about other aspects of their health - including sleep.
"We used sleep and wellness as novel hooks to get young people in the door," Fucito said. "There is often stigma associated with mental health concerns or substance use, which makes it difficult to talk about those things. But talking about how you sleep feels like a very benign, neutral topic."
In the 12-week study, participants were assigned to one of three groups: a group that received only web-based advice on sleep and alcohol; a group that received the web advice plus self-monitoring on a smartphone diary; and the biosensor/coaching group which received advice and smartphone diaries as well as personalized sleep and alcohol use health data and coaching.
While all groups showed significant decreases in drinking over time, the biosensor/coaching group achieved significant and clinically meaningful reductions in their alcohol risk level based on World Health Organization standards and improved their sleep health, the study found.
Authors from Yale also included Stephanie O'Malley, the Elizabeth Mears and House Jameson Professor of Psychiatry; Chiang-Shan Ray Li, a professor of psychiatry and neuroscience; Ash Garrett, an assistant professor of medicine and of biomedical informatics and data science; statistician Brian Pittman; Ran Wu, a statistician of psychiatry; and Kelly DeMartini, a research scientist of psychiatry. Researchers from Brown University and the University of Connecticut also contributed.
