{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T22:58:31Z","timestamp":1780613911152,"version":"3.54.1"},"reference-count":66,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,12,3]],"date-time":"2025-12-03T00:00:00Z","timestamp":1764720000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,12,3]],"date-time":"2025-12-03T00:00:00Z","timestamp":1764720000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Alcohol, Clinical and Experimental Research"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Sleep disturbances are highly prevalent among individuals with alcohol use disorder (AUD). Although sleep often improves during AUD treatment, associations with treatment outcomes have been inconsistent and have focused primarily on mean sleep parameters rather than daily within\u2010person variability. Sleep variability is an emerging marker of physiological dysregulation and is linked to negative symptoms that may sustain alcohol use.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Adults with AUD (\n                      <jats:italic>N<\/jats:italic>\n                      \u2009=\u200980) completed a 7\u2010day daily sleep diary and clinical assessments before and after a 12\u2010session outpatient psychotherapy treatment for AUD. Multilevel models examined pre\u2010 to post\u2010treatment changes in sleep variability. Multiple regression models tested whether changes in sleep variability predicted changes in alcohol use and psychosocial outcomes. All analyses used Bayesian estimation.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Variability in sleep onset latency (SOL; estimate\u2009=\u2009\u22124.43, 95% CI [\u22127.12, \u22121.40]), sleep midpoint (estimate\u2009=\u2009\u221218.77, 95% CI [\u221231.29, \u22124.13]), sleep efficiency (estimate\u2009=\u2009\u22121.87, 95% CI [\u22123.01, \u22120.61]), and number of awakenings (estimate\u2009=\u2009\u22120.17, 95% CI [\u22120.29, \u22120.04]) decreased across treatment. Variability in SOL emerged as the most robust predictor, with greater reductions in variability in SOL being associated with greater reductions in percentage drinking days (estimate\u2009=\u20090.01, 95% CI [0.001, 0.02]), drinks per drinking day (estimate\u2009=\u20090.10, 95% CI [0.001, 0.20]), and negative consequences from alcohol use (estimate\u2009=\u20090.51, 95% CI [0.24, 0.79]). Notably, improvements in mean\u2010level sleep parameters were not associated with improvements in any treatment outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>These results suggest that sleep variability, particularly in SOL, may be an important marker of treatment response and a potential target for future intervention above and beyond mean\u2010value sleep parameters. Future research would benefit from further examination into what drives changes in sleep variability as well as potential added benefits of adapting AUD treatments to include components that target sleep consistency.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/acer.70218","type":"journal-article","created":{"date-parts":[[2025,12,4]],"date-time":"2025-12-04T06:27:02Z","timestamp":1764829622000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Sleep variability as an important marker of treatment outcomes in a clinical sample receiving psychotherapy treatment for alcohol use disorder"],"prefix":"10.1111","volume":"50","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4367-7084","authenticated-orcid":false,"given":"Charles A.","family":"Manzler","sequence":"first","affiliation":[{"name":"Department of Psychology University of South Florida  Tampa Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jack","family":"Darkes","sequence":"additional","affiliation":[{"name":"Department of Psychology University of South Florida  Tampa Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cory A.","family":"Crane","sequence":"additional","affiliation":[{"name":"Department of Psychiatry University of Rochester  Rochester New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5470-102X","authenticated-orcid":false,"given":"Stephen A.","family":"Maisto","sequence":"additional","affiliation":[{"name":"Department of Psychology Syracuse University  Syracuse New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7743-1111","authenticated-orcid":false,"given":"Robert C.","family":"Schlauch","sequence":"additional","affiliation":[{"name":"Department of Psychology University of South Florida  Tampa Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,12,3]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.brat.2011.02.003"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598\u2010022\u201026019\u2010y"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.smrv.2015.06.003"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2008.10.003"},{"key":"e_1_2_9_6_1","first-page":"49","article-title":"How many days are needed for a reliable assessment by the sleep diary?","volume":"13","author":"Borba D.d.A.","year":"2023","journal-title":"Sleep Science"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1037\/1040\u20103590.3.3.433"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2213\u20102600(19)30057\u20108"},{"issue":"2","key":"e_1_2_9_9_1","first-page":"110","article-title":"Alcohol's effects on sleep in alcoholics","volume":"25","author":"Brower K.J.","year":"2001","journal-title":"Alcohol Research & Health"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1087\u20100792(03)90005\u20100"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1530\u20100277.1998.tb03995.x"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.5665\/sleep.3298"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/acer.13217"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/acer.14030"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0165331"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.sleh.2021.08.005"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0006\u20103223(97)00457\u20105"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2020.107905"},{"key":"e_1_2_9_19_1","doi-asserted-by":"crossref","unstructured":"Derogatis L.R.(1982)Brief Symptom Inventory (BSI)[Database record]. 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