0418 A Day-by-Day Prospective Analysis of Stress and Hypnotic Craving During Hypnotic Tapering in Insomnia

Abstract Introduction Craving plays a crucial role in the persistence and relapse of substance use. While hypnotic usage may differ from that of addictive substances, previous research has indicated that long-term use of hypnotics is associated with a craving for hypnotics among patients with insomnia. Stress, which is commonly linked to sleep disturbances, has also been shown to enhance cravings for substance use. The current study aims to investigate the relationship between stress and craving for hypnotics using day-to-day assessments. Methods Twenty-seven participants with insomnia disorder (age = 41.66 ± 12.88; Male:Female = 14:13), who had been taking hypnotics for more than three months, were recruited for a two-week study. During the first week, they were permitted to take their usual dosage of hypnotics, while in the second week, their dosage was reduced by 25%. Each night before bed, participants recorded the level of stress they experienced and their craving for hypnotics, both on a scale of 1 to 9. Data were collected through responses to questions delivered via a social media app (Line). Mixed Effects Models were utilized to examine the relationship between stress and craving, separating out between-subject and within-subject associations. Results The findings revealed no significant associations between stress and craving at the between-subject level for either week (β = -0.08, p = 0.77; β = 0.07, p = 0.80). However, at the within-subject level, there was a significant association between stress and craving during the usual dosage week (β = 0.22, p < .05), but not during the reduced dosage week (β = 0.14, p = 0.17). Conclusion Our study indicates that there is no significant correlation between stress and craving across the participants. Conversely, within individuals, heightened stress was correlated with increased craving when participants were allowed to take their usual hypnotic dosage. These results underscore the importance of taking stress into consideration when assisting insomnia patients in managing their cravings for hypnotics. Support (if any) National Science and Technology Council