Alcohol use among emerging adults constitutes a substantial public health concern, given its close association with a range of negative outcomes. Previous research has demonstrated that insufficient or poor-quality sleep exacerbates alcohol use and related outcomes, and that depression is intricately linked to both sleep and alcohol-related problems. While numerous studies suggest that alcohol craving may serve as a key mediator in the relationship between sleep disturbances and alcohol-related consequences, there remains a dearth of research focusing specifically on non-treatment-seeking emerging adults. In light of these gaps, the present study aims to clarify how sleep quality is associated with alcohol craving and negative alcohol-related outcomes among non-treatment-seeking emerging adults, and to determine whether depressive symptoms moderate these associations.
The study utilized 326 emerging adults from across the United States who reported alcohol use within the past year. Participants completed a survey that included demographic information, as well as measures of weekly alcohol consumption (DDQ), alcohol-related outcomes (B-YAACQ), alcohol craving (PACS), depressive symptoms (the depression subscale of the DASS-21), and sleep quality (PSQI). Descriptive statistics and correlation analyses were initially conducted. Subsequently, the PROCESS Macro was employed to examine the indirect effect (mediation) of sleep quality on alcohol-related outcomes and to determine whether depressive symptoms moderated this indirect pathway (moderated mediation).
According to the findings, participants consumed an average of 4.83 drinks per week and reported 2.97 alcohol-related consequences in the past month, along with a mean depression score of 12.19 and a mean global sleep quality score of 6.94. Correlational analyses revealed that poor sleep quality was positively associated with depression (r = 0.55, p < .001), alcohol craving (r = 0.20, p < .001), and alcohol-related consequences (r = 0.13, p = .015). Additionally, depression correlated positively with both alcohol craving (r = 0.26, p < .001) and alcohol-related consequences (r = 0.20, p < .001). Mediation analyses indicated a significant indirect effect of poor sleep quality on alcohol-related consequences through elevated alcohol craving (95% CI [0.03, 0.12]). However, moderated mediation analyses showed that depression symptoms did not significantly moderate this indirect pathway, suggesting that while poor sleep quality may exacerbate alcohol-related consequences via elevated craving, this effect does not differ according to individuals’ levels of depressive symptoms.
Takeaway: Alcohol craving may serve as a key factor connecting poor sleep quality with alcohol-related consequences among emerging adults.