Alcohol use disorder with metabolic dysfunction is associated with adverse sleep outcomes in a US clinical cohort.

Authors

Alexandra C Wagner, Jeesun Jung, Carolina Vela, Emily Hui, Tyler Perlstein, Joshua Reitz, LaToya Sewell, Melanie L Schwandt, Nancy Diazgranados, Josephin Wagner, Daniel B Rosoff, Falk W Lohoff

Published in

Alcohol and alcoholism (Oxford, Oxfordshire). Volume 61. Issue 6. Sep 20, 2026.

Abstract

Sleep is critical to health, yet its relationship to metabolic dysfunction (MD) in alcohol use disorder (AUD) remains understudied in US clinical populations.
1359 participants were recruited through the Natural History Protocol at the National Institutes of Health and categorized into four groups: healthy controls (HC), individuals with MD only (metHC), individuals with current AUD without MD (AUD), and individuals with both current AUD and MD (metAUD). Sleep was assessed using the Pittsburgh Sleep Quality Index (PSQI). Multinomial logistic regression models were used to test associations between sleep metrics and group status, adjusting for age, race, and sex (Model 1), and additionally for education, income, and smoking status (Model 2). Additional models examined sleep outcomes by MD severity (mild, <3; severe, ≥3 criteria) among AUD.
Thousand two hundred twenty participants were included: 155 HC, 397 metHC, 77 AUD, and 591 metAUD. Adverse sleep outcomes were associated with increased odds of metHC, AUD, and metAUD groups compared to HC, with the strongest associations observed for metAUD across multiple PSQI domains. Each one-category increase in sleep disturbance was associated with an eleven-fold increase in odds of metAUD relative to HC (OR: 11.71, 95% CI, 6.90-19.86). Associations remained significant in Model 2. Sleep disturbance and daytime dysfunction were also associated with increased odds of severe MD compared to AUD-only (false discovery rate < 0.05).
Adverse sleep outcomes were associated with increased odds of co-occurring MD in AUD, highlighting the clinical relevance of monitoring both sleep and metabolic health and the need for targeted intervention in this population.

PMID:
42993793
Bibliographic data and abstract were imported from PubMed on 07 Nov 2026.

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