TY  - JOUR
PY  - 2020//
TI  - Relationships between insomnia and alcohol and cocaine use frequency with aggression among veterans engaged in substance use treatment
JO  - Sleep Medicine
A1  - Sexton, Minden B.
A1  - Dawson, Spencer
A1  - Spencer, Robert J.
A1  - Phillips, David
A1  - Reckow, Jaclyn M.
A1  - Conroy, Deirdre A.
A1  - Winters, Jamie J.
A1  - Bonar, Erin E.
A1  - Chermack, Stephen T.
SP  - 182
EP  - 187
VL  - 83
IS  - 
N2  - BACKGROUND: Veterans with substance use problems have rates of partner and non-partner violence that typically exceed the general population. Sleep problems may exacerbate violence and maintain addictive behaviors in non-veterans, but requires study in veterans. Therefore, we examine the interrelationships between substance use, insomnia, and violence in veterans. <br><br>METHODS: Veterans (N = 762) screened for a randomized controlled trial at veterans affairs mental health and substance use clinics. Participants completed modified Conflict Tactics Scales to quantify past-year violence and the Insomnia Symptom Questionnaire to assess sleep disturbance. We evaluated associations between substance use and sleep in predicting the target of aggression (partner or non-partner) and degree of violence (aggression or injury) using binomial logistic regressions. <br><br>RESULTS: Half of participants endorsed symptoms suggestive of insomnia, 23.2% endorsed physical aggression toward partners (PA-P) and 33.9% non-partners (PA-NP), and 9.7% endorsed physical injury of partners (PI-P) and 17.6% of non-partners (PI-NP). Regressions revealed significant models for PA-P, PA-NP, and PI-NP, whereas the PI-P model was not significant. PA-P was higher among non-Caucasian race and older veterans. PA-NP was more common in those with insomnia and increased with frequency of cocaine use. Insomnia moderated the relationship between cocaine use and PA-NP; there was a weaker relationship between cocaine use and PA-NP in those with insomnia. PI-NP was more common with higher frequency of alcohol and cocaine use, and in those with insomnia. <br><br>CONCLUSIONS: This study finds sleep disturbances are meaningful predictors of violence among veterans with differential relationships with aggression severity, victims, and substance use concurrence.<p />  <p>Language: en</p>
LA  - en
SN  - 1389-9457
UR  - http://dx.doi.org/10.1016/j.sleep.2020.10.010
ID  - ref1
ER  -