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. Author manuscript; available in PMC: 2026 Apr 21.
Published in final edited form as: Alcohol Clin Exp Res (Hoboken). 2025 Jul 11;49(7):1554–1563. doi: 10.1111/acer.70080

Sleep disturbances relate to problematic alcohol use via effortful control and negative emotionality

Matison W McCool 1, Chloe E Martinez 1, Maria M Wong 2, Matthew R Pearson 1; Protective Strategies Study Team
PMCID: PMC13094386  NIHMSID: NIHMS2160683  PMID: 40643888

Abstract

Background:

Sleep disturbances, such as insomnia, are highly prevalent among college students. Alcohol use (and other substance use) peaks during emerging adulthood (18-25 years old). Short sleep duration and sleep disturbances have been shown to be a risk marker for the development of problematic alcohol use. Putative mechanisms that account for this relationship include facets of executive functioning and emotion regulation.

Methods:

In a large cross-sectional sample of college students (n=5,074), we examined the relationship between insomnia symptoms and problematic alcohol use (negative consequences and alcohol use disorder symptoms) via negative emotionality (stress, depression, anxiety, social anxiety) and effortful control (activation, attentional, and inhibitory) using structural equation modeling with bootstrapping (CFI=.979, TLI=.971, RMSEA=.038 (90% CI: .035, .041), SRMR=.045).

Results:

Insomnia symptoms were associated with higher negative emotionality (β=.539, p<.001) and lower effortful control (β=−.283, p<.001); negative emotionality (β=.207, p<.001) and effortful control (β=−.267, p<.001) were each related to problematic alcohol use. The relationship between insomnia and problematic alcohol use (β=.173, p<.001) dropped to non-significance when controlling for negative emotionality and effortful control (β=−.014, p=.698).

Conclusions:

Although the cross-sectional nature of the data prohibits causal inference, these indirect effects support the plausibility that facets of executive functioning and emotion regulation account for the relationship between insomnia symptoms and problematic alcohol use. Understanding the relationships among these factors can help guide the development and tailoring of effective interventions that target sleep-alcohol use dynamics.

Keywords: Sleep, Alcohol, Effortful Control, Negative Emotions, College Students

Introduction

The college experience, commonly defined as a period of academic rigor and independence, frequently includes sleep challenges that prevent students from getting adequate and restful sleep. Sleep is vital to one’s overall wellbeing, and a staggering 70-90% of college students report sleeping less than 8 hours on weeknights. Alongside this, alcohol and substance use peaks during emerging adulthood (18-25 years old). Previous findings highlight short sleep duration and insomnia symptoms as risk markers for the development of problematic alcohol use (Chakravorty et al., 2018; Colrain et al., 2009; Hasler and Pedersen, 2020; Wong et al., 2010a, 2015). Insomnia symptoms include trouble falling asleep, maintaining sleep, waking up earlier than planned (Drake and Fernandez-Mendoza, 2022). In this report, the relationship between insomnia symptoms and problematic alcohol use is examined via controlling for negative emotionality and effortful control. By examining the complexities of this relationship, we aim to unveil valuable insights that can be used to guide the future development and tailoring of interventions aimed to promote healthier sleeping patterns and mitigate the risks associated with problematic alcohol use.

Sleep and Alcohol Use

It is recommended that adults receive at least 7 hours of sleep per night, and over one third of adults did not meet that recommendation in 2020 (“National Center for Chronic Disease Prevention and Health Promotion DoPH. National trends in short sleep duration among US adults,” 2022). Additionally, upwards of 14% of adults experience insomnia symptoms (Adjaye-Gbewonyo et al., 2022). Troubles surrounding sleep are exacerbated amongst college students, about a quarter of whom (26.4%) report experiencing insomnia symptoms (Mbous et al., 2022), and 70-90% of sleep less than 8 hours a night on weeknights (Bachman and Bachman, 2006; Hershner, 2015; Lund et al., 2010). Poor sleep quality among college students has been linked to a variety of negative consequences, such as reduced academic success, mood disturbances, higher rates of participation in unhealthy risk-taking behaviors (DeMartini and Fucito, 2014; Kenney et al., 2012).

Quality sleep is important for young adults, as quality sleep is necessary for brain development and functioning (Campbell and Feinberg, 2009; Feinberg and Campbell, 2010), especially considering the brain does not fully mature until a person reaches their mid-twenties (Kuula, 2018; Walker, 2008). The prefrontal cortex of the brain is particularly sensitive to poor sleep quality (Venkatraman et al., 2011, 2007). Sleep deprivation may lead to increased reactivity to negative emotional stimuli, and increased reward-seeking behavior, potentially due, in part, to changes in the prefrontal cortex (Gujar et al., 2011). The relationship between sleep and the prefrontal cortex is important regarding alcohol use, as the prefrontal cortex plays a central rolein controlling inhibitions and regulating emotions (Blasi, 2006; Hariri et al., 2003). Functional magnetic resonance imaging (f-MRI) data has shown that when sleep deprived, individuals exhibited an amplified, hyper-limbic response in their amygdala in response to negative emotional stimuli. This increased limbic activity was associated with a loss of functional connectivity with the medial prefrontal cortex, indicating diminishing top-down, prefrontal control (van der Helm and Walker, 2012; Yoo et al., 2007). Sleep deprivation was also associated with an amplified reactivity in the human mesolimbic reward brain networks in response to pleasure-evoking stimuli (Goldstein and Walker, 2014; Gujar et al., 2011). Dysregulation in the brain circuitry related to inhibition control and emotion regulation is associated with risky alcohol use and other risky behaviors (Casey et al., 2008; Steinberg, 2008; Zucker et al., 2011).

Alcohol and problematic alcohol use (e.g., binge drinking) are most prevalent amongst Americans aged 18 to 25-years-old , with almost a third reporting binge drinking in the past month, and 6.4% reported binge drinking at least 5 days in the past month (Substance Abuse and Mental Health Services Administration, 2021). The deleterious effects of alcohol on many aspects of sleep and daytime sleepiness are well-documented (Roehrs and Roth, 2001), though less work examined the effects of sleep on alcohol use. However, longitudinal studies provided evidence that childhood sleep problems predicted the early onset of alcohol and other substance use in adolescence (Wong et al., 2009, 2004), and alcohol-related problems in young adulthood.(Wong et al., 2010b). The pattern of sleep predicting subsequent alcohol-related problems is strengthened by studies that used national samples, where sleep problems predict subsequent drinking-related outcomes, even when controlling for alcohol use at previous time points (Wong et al., 2015), while additional research suggests a bidirectional pattern of variations in sleep and alcohol use over time (Fucito et al., 2018). There is robust literature providing strong evidence of insomnia symptoms preceding alcohol use(Roane and Taylor, 2008; Weissman et al., 1997), and the identification of problematic sleep during childhood and adolescence as a risk factor for developing future alcohol use disorder (Hasler et al., 2014; Shibley et al., 2008). Still, there is a further need to explore the mechanisms by which sleep affects alcohol use.

Effortful Control, Sleep, and Alcohol use

Effortful control is the ability to inhibit a dominant response to perform a subdominant response (Rothbart and Bates, 1998, p. 137). It refers to a person's ability to regulate emotions, thoughts, and behaviors (Santens et al., 2020). Effortful control involves the ability of voluntarily activating (activation control) and inhibiting behavioral responses (inhibitory control) and shifting attention to meet one’s changing goals (attention control) (Rothbart and Rueda, 2005; Rueda, 2012). Previous research suggests a bidirectional relationship between sleep characteristics and effortful control. Specifically, more difficulty with effortful control is associated with decreased sleep hygiene and sleep quality, and increased insomnia severity (Lukowski and Tsukerman, 2021). Additionally, disturbances in sleep are associated with problems with effortful control and executive functioning (Kuula, 2018; Lukowski and Milojevich, 2015), which may then affect further downstream behaviors such as negative thinking (Cox et al., 2018).

Difficulty with effortful control is associated with negative alcohol-related outcomes such as problematic alcohol use (Piehler et al., 2012) and alcohol-related problems (Wong and Rowland, 2013). While less difficulty with effortful control is typically a protective factor against alcohol-related harms and other risky behaviors (Santens et al., 2020). There is further evidence that the relationship between sleep problems and effortful control may lead to increased risks for problems related to drug and alcohol use. In one longitudinal study, sleep problems in early childhood (3-5 years old) were associated with decreased response inhibition (a measure of behavioral effortful control) in adolescence, which in turn predicted increased drug use (Wong et al., 2010b).

Negative Emotionality, Sleep, and Alcohol use

Negative emotions (e.g., sadness, fear, anger, etc.) are the experience of an unwanted or distressing physiological state (Koob and Volkow, 2010). Research suggests a bidirectional relationship between sleep and negative emotionality. While specific instances of sleep deprivation are likely to increase negative emotionality (Talbot et al., 2010), chronic lack of sleep also tends to increase neural reactivity to negative, and positive, stimuli (Gujar et al., 2011; Yoo et al., 2007). These relationships could be in part due to the role of sleep in the regulation of cognition and emotion (Walker, 2009; Walker and Helm, 2009). Negative emotions and regulating negative emotions are cross-sectionally associated with increased problems related to alcohol use (Paulus et al., 2021; VanderVeen et al., 2016). Additionally, college students who report low sleep quality tend to endorse high levels of negative emotions, use alcohol for sleep, and report drinking more beverages with alcohol in them (Lund et al., 2010). While the links between sleep, negative emotions, and alcohol are relatively well established, little work has focused on the mechanistic relationships between sleep, negative emotionality, and alcohol-related problems (Hasler and Pedersen, 2020).

Present Study

The present study examines the relationships between insomnia symptoms, effortful control, negative emotionality, and alcohol-related problems. Specifically, we propose an indirect effect model in which the relationship between insomnia symptoms and alcohol-related problems is accounted for by effortful control and negative emotionality. First, we use a confirmatory factor analysis to model latent constructs of insomnia symptoms, effortful control, negative emotionality, and alcohol-related problems. Then, we hypothesize that the latent constructs of effortful control and negative emotionality will account for the indirect effect of insomnia on alcohol-related problems. Specifically, we hypothesize that more insomnia symptoms will be associated with greater negative emotionality and decreased effortful control, which will be associated with more alcohol-related problems.

Materials and Methods

Participants

College students from 10 universities across 10 U.S states were recruited from Psychology Department Participant Pools to be participants in an online survey (n = 7,307). All data were collected using the same software (i.e., Qualtrics) to ensure data collection was standardized at each site. Each participant received and completed a battery of core measures focusing on substance use. After the completion of core measures, each participant received a random sample of 10 measures from a larger pool of 19 total measures, assessing mental health (e.g., depression, anxiety, stress, self-esteem, suicide, and posttraumatic stress) and personality constructs (e.g., impulsivity-like traits, Big Five personality traits, antisocial behavior, and temperament). Based on those who completed at least some of the measures used in our analyses and restricting analyses to those who reported drinking alcohol in the past 30 days, our analytic sample size was 5,074. Most of the analytic sample was White (73.80%), female (71.3%), and reported a mean age of 20.89 (median = 20.00, SD = 4.43) years. Research participation credit was provided in exchange for participant’s completion of the study. This protocol was approved by the institutional review boards at each participating university.

Measures

Insomnia Symptoms.

Insomnia symptoms in the past two weeks were assessed with the 7-Item Insomnia Severity Index (Bastien et al., 2001), measured with a 5-point response scale (0=none/very satisfied, 4=very/very dissatisfied, Cronbach’s α=0.880). Using a clinical cut-off score of 8, the Insomnia Severity Index and has shown to be a valid screener of insomnia severity in college student samples (Emert et al., 2024). Sleep problems in the past month were assessed using 4 items from the Sleep Problems Questionnaire (Jenkins et al., 1988), measured on a 6-point response scale (0=not at all, 5=22-31 days, Cronbach’s α=0.869). Sleep problems in the past 6 months were assessed using 7 items from the Sleep Disorders Questionnaire (Douglass et al., 1994) measured on a 5-point response scale (0=never/strongly disagree, 5=always/agree strongly, Cronbach’s α=0.926).

Effortful Control.

Effortful control was assessed using the 19-Item effortful control subscale of the Adult Temperament Questionnaire (ATQ) (Evans and Rothbart, 2007) measuring effortful attention (Cronbach’s α=0.620), activational control (Cronbach’s α=0.629), and inhibitory control (Cronbach’s α=0.419) on a 7-point response scale (1=extremely untrue of you, 7=extremely true of you). Although these internal consistency estimates are low, they are consistent with internal consistencies reported for these abbreviated scales in previous research (e.g., .487< Cronbach’s α <.634; Wiltink et al., 2006).

Negative Emotionality.

Social anxiety was assessed using the 21-Item Social Interaction Anxiety Scale (SIAS) (Nilsson et. al., 2011), measured on a 5-point response scale (0= not at all characteristic or true of me, 4= extremely characteristic or true of me). Items were summed (M=25.18, SD=15.51, Cronbach’s α=0.936). The 21-Item Depression Anxiety Stress Scale (DASS-21) (Crawford and Henry, 2003), measured on a 4-point response scale (0=did not apply to me at all, 3=applied to me very much/or most of the time), was used to assess depression (7 items, M=3.36, SD=4.41, Cronbach’s α=0.924), anxiety (7 items, M=3.16, SD=3.84, α=.858), and stress or the sensitivity to chronic non-specific arousal (7 items, M=4.16, SD=4.26, Cronbach’s α=0.881).

Alcohol Problems.

Alcohol problems were assessed by summing 7 items from the US Alcohol Use Disorders Identification Test (Babor et al., 2016) that assess alcohol problems (M= 2.42, SD=3.55, Cronbach’s α=0.777), 5 items measured on a 5-point response scale (0=Never, 4=daily or almost daily) and 2 items measured on a 3-point response scale (0=No, 2=Yes, but not in the last year, 4=Yes, during the last year). For calculating cutoffs for hazardous drinking and likely alcohol use disorder, we used the US AUDIT total score, which also includes 3 consumption items measured on a 7-point response scale. Negative alcohol-related consequences were assessed using the 24-Item Brief Young Adult Alcohol Consequences Questionnaire (BYAACQ) (Kahler et al., 2005), measured on a binary response scale (0=no, 1=yes). All items were then summed to create a composite score reflecting the number of distinct problems experienced in the past 30 days (M=5.63, SD=5.32, Cronbach’s α=0.904)

Analysis Plan

Statistical analyses were conducted with Mplus 8.10 (Muthén and Muthén, 2020). Our plan was to first conduct a confirmatory factor analysis to determine if each measured indicator loaded substantially on each latent construct, and to determine whether the measurement model fit the data well. Model fit was evaluated using a combination of indices (Hu and Bentler, 1999), including the Comparative Fit Index/Tucker-Lewis Index (CFI/TLI; ≥.90 is acceptable), Root Mean Square Error of Approximation (RMSEA; ≤.06 is acceptable), and Standardized Root Mean Square Residual (SRMSR; ≤.08 is acceptable). If model fit was acceptable, we would then examine the proposed mediation model such that the association between sleep and alcohol problems would be mediated by effortful control and negative emotionality. To examine total, direct, and indirect effects, we used bias-corrected bootstrapped confidence intervals with 10,000 draws (Efron and Tibshirani, 1993). Next, we expected to conduct measurement invariance testing using multigroup confirmatory factor analysis across sex assigned at birth. Specifically, we would examine configural (equivalent factor structure), metric (equivalent factor loadings), scalar (equivalent item intercepts), and structural (equivalent inter-factor associations) invariance using the same model fit indices described above. Given the potential over sensitivity of chi-square difference tests, we used model comparison criteria of a decrease in CFI≥.01 (Cheung and Rensvold, 2002) or an increase in RMSEA≥.015 (Chen, 2007) to indicate significant decrement in fit when testing for metric, scalar, and structural invariance. Metric invariance is requisite to be able to validly compare covariances across groups, and scalar invariance is requisite to be able to validly compare latent means across groups. Latent mean differences were examined across groups, pending support for the scalar invariance model.

Results

Descriptive Statistics

Based on the Insomnia Severity Index, 54.2% of our sample reported no clinically significant insomnia (0-7), 31.8% reported subthreshold insomnia (8-14), 12.1% reported moderate severity clinical insomnia (15-21), and 1.9% reported severe clinical insomnia (22-28). Based on the sex-specific cutoffs developed for college students for the US AUDIT (McCabe et al., 2019) total score. 86% of males in our sample was classified as at-risk drinkers (score 5+) and 69.3% of females in our sample (score 6+ for females).

Measurement Model

A confirmatory factor analysis examining our proposed measurement model had good model fit, χ2(48)=399.07, p<.001, CFI=.979, TLI=.971, RMSEA=.038 (90% CI: .035, .041), SRMR=.045. Standardized factor loadings were high across each construct including indicators of sleep disturbances (.87<λs<.93), negative emotionality (.53<λs<.92), effortful control (.51<λs<.69), and alcohol problems (.74<λs<.84). There were significant correlations between all latent factors (p’s <0.001). Specifically, negative emotionality was negatively related to effortful control (r=−0.50) and positively with insomnia symptoms (r=0.54) and alcohol problems (r=0.33). Effortful control was negatively related to both insomnia symptoms (r=−0.28) and alcohol problems (r=−0.37). Lastly, insomnia symptoms was positively correlated with alcohol problems (r=0.17).

Structural Model

We examine our proposed structural equation model that examined the associations between sleep and alcohol problems via indirect effects on negative emotionality and effortful control, allowing negative emotionality and effortful control to covary (see Figure 1). Consistent with our hypotheses, poor sleep was associated with higher negative emotionality (β=.54) and lower effortful control (β=−.28), which were moderately correlated with each other (β=−.43). Further, higher negative emotionality was associated with higher alcohol problems (β=.21) and higher effortful control was associated with lower alcohol problems (β=−.27). When controlling for negative emotionality and effortful control, the effect of sleep on alcohol problems was not significant (β=−.01).

Figure 1.

Figure 1.

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Structural equation model of the relationships between sleep and alcohol problems via negative emotionality and effortful control

Note. Although not depicted for parsimony, negative emotionality and effortful control were allowed to covary (β=−.43, p<.001).

Based on the bias-corrected bootstrapped confidence intervals, we found a significant total effect of sleep on alcohol problems. Further, the total indirect effect and the specific indirect effects of sleep on alcohol problems via negative emotionality and effortful control were significant, whereas the direct effect of sleep on alcohol problems was non-significant and near zero.

Measurement Invariance

Across sex assigned at birth, we found our measurement model to fit well in the configural invariance model (see Table 3). Decrements in model fit for the metric and scalar invariant models were not substantial (i.e., CFI did not decrease by .01 or more, RMSEA did not increase by .015 or more), indicating that we could assume equivalent factor loadings and item intercepts, and thus meaningfully interpret latent mean differences. The scalar invariant model revealed that females reported moderately higher sleep problems (M=.347, p<.001, d=.335), slightly lower alcohol problems (M=−.174, p<.001, d=.185), slightly higher negative emotionality (M=.098, p=.014, d=.100), and slightly lower effortful control (M=.112, p=.042, d=.112) compared to males. Yet, as the decrement in model fit for the structural invariant model was not substantial, we can conclude that the associations among sleep and alcohol problems via negative emotionality and effortful control were statistically equivalent across males and females.

Table 3.

Measurement invariance testing across sex assigned at birth (0=male, 1=female).

Model Comparisons
χ2 df p CFI TLI RMSEA LB UB SRMR Δχ2 Δdf p ΔCFI ΔRMSEA
1. Configural 427.955 96 <.0001 0.980 0.973 0.037 0.033 0.041 0.046 1 vs 2 28.393 8 .0004 −.001 +.000
2. Metric 456.348 104 <.0001 0.979 0.973 0.037 0.033 0.04 0.048 1 vs 3 133.508 16 <.0001 −.007 +.003
3. Scalar 561.463 112 <.0001 0.973 0.968 0.040 0.037 0.043 0.05 2 vs 3 105.115 8 <.0001 −.006 +.003
4. Structural 577.686 118 <.0001 0.972 0.969 0.039 0.036 0.042 0.052 3 vs 4 16.223 6 0.013 −.001 −.001
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Alternative Models

Given that social anxiety loaded less strongly onto our negative emotionality factor, we conducted an alternative model removing this indicator (Alternative Model 1). Results were remarkably similar (see Supplemental Table 1 and Supplemental Figure 2). We also examined two separate models with each of our alcohol outcomes as measured indicators. Although the association between effortful control and alcohol consequences measured by the BYAACQ was a little stronger and the associations between negative emotionality and alcohol consequences measured by the USAUDIT was a little stronger, the pattern of significant direct, indirect, and total effects remained the same (see Supplemental Table 1 and Supplemental Figures 3-4). Last, we considered the potential of the reverse model, that is alcohol problems leading to insomnia symptoms through negative emotionality and effortful control. Results indicated that neither effortful control or alcohol problems had a direct effect on insomnia symptoms (Supplemental Table 1 and Supplemental Figure 5). However, there was a significant indirect effect of alcohol problems on insomnia symptoms through negative emotionality (Supplemental Table 2).

Discussion

Overall, the results demonstrate that negative emotionality and effortful control likely play a key role in the relationship between insomnia symptoms and alcohol-related problems in college students. Specifically, our study is one of the first to provide evidence that both effortful control and negative emotionality mediate the relationship between insomnia symptoms and alcohol-related problems. Sleep affects how the body and brain regulate different emotional and situational processes (Hasler and Pedersen, 2020; Kuula, 2018). Insomnia symptoms results in inadequate sleep. When sleep-deprived, the amygdala shows an amplified response to negative emotional stimuli (Yoo et al., 2007). The increase in limbic activity was associated with a loss of functional connectivity between the amygdala and the medial-prefrontal cortex, indicating a decrease in top-down, prefrontal control of emotions and behaviors (Walker, 2017, 2009; Yoo et al., 2007). The amygdala and prefrontal cortex are also linked to deficits in decision-making processes throughout the addiction cycle, and detriments in these areas increase the risk of developing and alcohol use disorder (Koob and Volkow, 2010). It is likely that sleep disturbances are affecting the capacity of college students to regulate negative emotions and behavioral responses as well as increasing other factors affecting effortful control (e.g., impulsivity). These negative sequalae of sleep disturbances are a concern for college students, as they tend to be sleep-deprived (Hershner, 2015), and have ample opportunities to engage in risky drinking behaviors (National Center for Chronic Disease Prevention and Health Promotion, 2022). Increased negative emotionality and poor effortful control due to insomnia symptoms likely make it more difficult to set and attain goals related to responsible drinking.

Limitations and Future Directions

Our study had several limitations to consider. First, we only included participants that endorsed past 30-day alcohol use, and the results may not generalize to very infrequent drinkers. Also, the cross-sectional study design prevents the examination of true mediation in that we are unable to establish temporal precedence or make causal inferences. However, our findings of the indirect effects of insomnia symptoms on alcohol problems support the plausibility that effortful control and negative emotionality mediate these associations. Further, measurement of mediation approaches have been increasingly criticized in favor of design-based approaches (Bullock and Green, 2021). Therefore, longitudinal and experimental studies (e.g., clinical trials) that specifically target sleep, effortful control, and negative emotionality are needed to test the proposed process model. For example, distinct interventions that target sleep, negative emotionality, and effortful control could be microrandomized in an intensive longitudinal trial to better understand the causal linkages between each of these constructs.

Future work in this area would benefit from including additional measures of self-regulation, or one’s ability to regulate negative emotions in addition to inhibiting responses to stimuli, to understand if it is negative emotionality itself, or one’s ability to regulate those emotions, that is driving the observed indirect effects. The use of objective indicators of sleep quality (e.g., actigraphy) and alcohol use (e.g., transdermal alcohol sensors) would enhance our ability to ensure that these findings are not driven by self-report biases.

In our reverse alternative model, the indirect effect of negative emotionality remained significant while effortful control did not. The differences in mediation pattern, should be approached with caution in our sample, and may also indicate the bidirectional relationship between sleep and alcohol problems could have different mechanistic factors. Unique mechanisms could be established through longitudinal methodologies better suited to infer causation and establish distinct mechanistic functions. Negative emotionality could be a shared feature in a cyclic relationship such that sleep problems increase negative emotionality, which in turn increases alcohol problems, which leads to further negative emotionality, sleep problems, and so on.

Conclusions

In all, our study is one of the first to examine whether both effortful control and negative emotionality mediate (explain) the relationship between insomnia symptoms and alcohol-related problems in college students. Our results suggest that insomnia may decrease regulatory abilities and increase negative emotionality, which in turn leads to more alcohol-related problems for college students. Considering college students are the most likely age group to engage in risky drinking behaviors and tend to endorse high sleep problems, understanding the mechanistic pathways between the two could lead to more effective and efficient treatment opportunities.

Supplementary Material

Supp

Table 1.

Descriptive Statistics and Bivariate Correlations

1 2 3 4 5 6 7 8 9 10 11 12
1. Insomnia (ISI) ---
2. Sleep Problems (past month) (SPQ) .771* ---
3. Sleep Problems (past 6 months) (SDQ) .807* .833* ---
4. Stress (DASS) .496* .420* .452* ---
5. Depression (DASS) .450* .369* .390* .792* ---
6. Anxiety (DASS) .438* .345* .373* .802* .750* ---
7. Social Anxiety (SIAS) .327* .269* .288* .490* .510* .466* ---
8. Activation Control (ATQ) −.183* −.085* −.113* −.236* −.295* −.241* −.300* ---
9. Attentional Control (ATQ) −.274* −.244* −.246* −.317* −.302* −.286* −.289* .390* ---
10. Inhibitory Control (ATQ) −.167* −.089* −.125* −.135* −.113* −.132* −.153* .370* .297* ---
11. Alcohol Consequences (BYAACQ) .154* .066* .110* .212* .219* .239* .063* −.225* −.123* −.216* ---
12. Alcohol Problems (AUDIT-Probs) .164* .099* .130* .265* .283* .298* .113* −.220* −.133* −.139* .621* ---
Mean 7.83 2.50 2.39 4.16 3.36 3.16 25.18 4.75 1.21 4.23 5.63 2.83
SD 5.71 1.28 1.03 4.26 4.41 3.84 15.51 .98 1.09 .86 5.32 3.75
Skewness .729 .893 .464 1.182 1.615 1.623 .644 −.119 .126 .237 1.145 1.892
Kurtosis .016 .071 −.598 1.026 2.219 2.655 −.044 −.279 −.154 .127 .897 4.036
n 2593 2590 2593 2601 2601 2601 2615 2606 2601 2603 5073 5066
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Note. ISI = Insomnia Severity Index, SPQ = Sleep Problems Questionnaire, SDQ = Sleep Disorders Questionnaire, DASS = Depression Anxiety Stress Scales, ATQ = Adult Temperament Questionnaire, BYAACQ = Brief Young Adult Alcohol Consequences Questionnaire, AUDIT = Alcohol Use Disorder Identification Test.

*

p < .01

Table 2.

Summary of total, indirect, and direct effects of sleep on alcohol problems via negative emotionality and effortful control

B 95% CI β 95% CI
Total .137 .099, .176 .173 .127, .220
Total indirect .148 .113, .183 .187 .143, .232
 Negative Emotionality .088 .051, .125 .111 .063, .160
 Effortful Control .060 .037, .083 .076 .049, .102
Direct −.011 −.065, .044 −.014 −.083, .055
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Note. Significant associations are in bold typeface for emphasis and were determined by a 95% bias-corrected standardized bootstrapped confidence interval (based on 10,000 bootstrapped samples) that does not contain zero. Total indirect reflects the combined indirect associations within the model.

Acknowledgments

Matison McCool was supported in part by the National Institute on Alcohol Abuse and Alcoholism, T32AA018108 (PI: Witkiewitz); K23AA031729; PI: McCool).

**PSST includes the following investigators:

Matthew R. Pearson, University of New Mexico (Coordinating PI); Adrian J. Bravo, University of New Mexico (Co-PI); Mark A. Prince, Colorado State University (site PI); Michael B. Madson, University of Southern Mississippi (site PI); James M. Henson, Old Dominion University (site PI); Alison Looby, University of Wyoming (site PI); Vivian M. Gonzalez, University of Alaska-Anchorage (site PI); Amber M. Henslee, Missouri Science & Technology (site PI); Carrie Cuttler, Washington State University (site PI), Maria M. Wong, Idaho State University (site PI), Dennis E. McChargue, University of Nebraska-Lincoln (site PI).

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