ABSTRACT
Purpose: Young adults report the highest rates of heavy drinking and are a priority population for alcohol prevention and early intervention. Yet, current alcohol interventions for young adults have modest effects, and young adults rarely self-identify for help with their drinking. Thus, other onramps to alcohol preventive services are needed. Young adults are concerned about sleep and health so embedding alcohol-related content within other health programs and connecting alcohol use to health outcomes may be a useful strategy. We conducted a randomized-controlled trial to test 3 sleep intervention components for promoting alcohol and sleep behavior change. Methods & Data: We randomized 120 young adults (18-25 years) who reported recent heavy drinking using a 1:1:2 ratio to 1 of 3, 2-week interventions: (1) 2-module mobile sleep hygiene advice (A;n = 30), (2) advice + sleep/alcohol daily diary self-monitoring (A+SM;n = 30), or (3) advice, selfmonitoring, personalized sleep/alcohol feedback (A+SM+F;n = 60). All wore sleep and alcohol biosensors. At intake, week 4, and week 12, participants completed the Timeline Followback Interview for alcohol use, measures of sleep disturbance, sleep-related impairment, and alcohol-related consequences. Nearly half (44%) completed enrollment and/or follow-up during the COVID-19 pandemic, but results are summarized for the whole sample. Results: The sample included 51% female, 80% white, 16% Hispanic, and 73% students. Over the past 4 weeks at intake, they consumed 86.58 ± 43.21 total drinks (primary outcome) and drank a maximum of 11.82 ± 4.84 drinks. All subjects significantly reduced total number of drinks over time, but there was no significant group effect on this outcome. There were group effects on sleep disturbance [p = 0.05] and sleep-related impairment [p = 0.02], which favored A+SM+F vs. A (d = 0.53 and d = 0.67, respectively). An overall group effect approached significance (p = 0.069) for alcohol related consequences driven by fewer consequences observed in A+SM+F vs. A (d = 0.52). Treatment satisfaction (0-4 scale) (3.53 ± 0.61), treatment completion (98%), and follow-up retention were high (96%) and did not vary by group. Conclusions: Results provide support for the feasibility and acceptability of brief sleep interventions that integrate alcohol content in heavy-drinking young adults. Findings also suggest that personalized feedback about sleep, alcohol use, and their association may be promising for improving sleep and alcohol-related harmin this high-risk group.