Sleep and the cholinergic rem sleep induction test in patients with primary alcoholism.

Author(s): Gann HJ, Faulmann A, Kiemen A, Klein T, Ebert D, Backhaus J, Hornyak M, Voderholzer U, Hohagen F, Berger M, Riemann D

Affiliation(s): Department of Psychiatry and Psychotherapy, University of Freiburg, Freiburg, D-79104, Germany.

Publication date & source: 1998, Sleep Res Online., 1(2):92-5.

Publication type: Clinical Trial; Controlled Clinical Trial; Randomized Controlled Trial

Sleep disturbances of alcoholics while actively drinking and at the beginning of, and during, abstinence were frequently reported. Recently, Gillin et al. (1994) showed that a high "REM sleep pressure" at the time of admission to a 1-month inpatient alcohol treatment program predicted the relapse in nondepressed patients with primary alcoholism at 3 months following hospital discharge. We investigated 24 patients with primary alcoholism after 2-3 weeks abstinence in the sleep laboratory; in 15 of these patients the cholinergic REM sleep induction test (CRIT) with 10 mg galanthamine was performed additionally. In comparison with an age- and sex-matched healthy control group, patients had a heightened "REM sleep pressure" including shortened REM latency and increased REM density. A decrease of serotonergic neurotransmission is proposed as being the neurochemical mechanism to explain the results in alcoholic subjects. Follow-up investigations will clarify whether the sleep abnormalities in alcoholism are state- or trait-markers and whether they are suitable to predict the relapse risk.