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Association between alcohol consumption and sleep traits: observational and mendelian randomization studies in the UK biobank

Molecular Psychiatry (2024)Cite this article

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Abstract

Previous studies have shown that excessive alcohol consumption is associated with poor sleep. However, the health risks of light-to-moderate alcohol consumption in relation to sleep traits (e.g., insomnia, snoring, sleep duration and chronotype) remain undefined, and their causality is still unclear in the general population. To identify the association between alcohol consumption and multiple sleep traits using an observational and Mendelian randomization (MR) design. Observational analyses and one-sample MR (linear and nonlinear) were performed using clinical and individual-level genetic data from the UK Biobank (UKB). Two-sample MR was assessed using summary data from genome-wide association studies from the UKB and other external consortia. Phenotype analyses were externally validated using data from the National Health and Nutrition Examination Survey (2017–2018). Data analysis was conducted from January 2022 to October 2022. The association between alcohol consumption and six self-reported sleep traits (short sleep duration, long sleep duration, chronotype, snoring, waking up in the morning, and insomnia) were analysed. This study included 383,357 UKB participants (mean [SD] age, 57.0 [8.0] years; 46% male) who consumed a mean (SD) of 9.0 (10.0) standard drinks (one standard drink equivalent to 14 g of alcohol) per week. In the observational analyses, alcohol consumption was significantly associated with all sleep traits. Light-moderate-heavy alcohol consumption was linearly linked to snoring and the evening chronotype but nonlinearly associated with insomnia, sleep duration, and napping. In linear MR analyses, a 1-SD (14 g) increase in genetically predicted alcohol consumption was associated with a 1.14-fold (95% CI, 1.07–1.22) higher risk of snoring (P < 0.001), a 1.28-fold (95% CI, 1.20–1.37) higher risk of evening chronotype (P < 0.001) and a 1.24-fold (95% CI, 1.13–1.36) higher risk of difficulty waking up in the morning (P < 0.001). Nonlinear MR analyses did not reveal significant results after Bonferroni adjustment. The results of the two-sample MR analyses were consistent with those of the one-sample MR analyses, but with a slightly attenuated overall estimate. Our findings suggest that even low levels of alcohol consumption may affect sleep health, particularly by increasing the risk of snoring and evening chronotypes. The negative effects of alcohol consumption on sleep should be made clear to the public in order to promote public health.

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Fig. 1: Study flow diagram illustrating data collection and analysis.
Fig. 2: Epidemiological associations between alcohol consumption and sleep traits.
Fig. 3: Result of linear Mendelian randomization analysis of alcohol consumption with sleep traits as outcomes.
Fig. 4: Result of nonlinear Mendelian randomization analysis of alcohol consumption with sleep traits as outcomes.

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Acknowledgements

This work was supported by the Ministry of Science and Technology of China (Nos. 2021ZD0202101, and 2021ZD0201900), and the National Natural Science Foundation of China (Nos. 82130040, and 82288101). This study was conducted using the UK Biobank resource (Application Number 48344) and NHANES. We are grateful to all participants and researchers involved in these prospective cohort.

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  1. These authors contributed equally: Jun-Wei Zheng, Si-Zhi Ai.

Authors and Affiliations

  1. National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, 100191, Beijing, China

    Jun-Wei Zheng, Shi-Qiu Meng, Tian-Qi Di, Wang-Yue Liu, Xiao-Qin Yang, Na Zeng, Yan-Ping Bao, Yan Sun & Jie Shi

  2. Department of Pharmacology, School of Basic Medical Sciences, Peking University Health Science Center, 100191, Beijing, China

    Jun-Wei Zheng, Tian-Qi Di, Wang-Yue Liu & Xiao-Qin Yang

  3. Center for Sleep and Circadian Medicine, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, 510182, China

    Si-Zhi Ai

  4. Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou, 511436, China

    Si-Zhi Ai

  5. Institute of Psycho-neuroscience, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, 510120, China

    Si-Zhi Ai

  6. Peking University Sixth Hospital, Peking University Institute of Mental Health, Key of Mental Health, Ministry of Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), 100191, Beijing, China

    Su-Hua Chang, Le Shi, Jia-Hui Deng, Xiang-Wen Chang, Jing-Li Yue & Lin Lu

  7. School of Public Health, Peking University, 100191, Beijing, China

    Na Zeng

  8. Peking-Tsinghua Center for Life Sciences and International Data Group/McGovern Institute for Brain Research, Peking University, 100191, Beijing, China

    Lin Lu

  9. The State Key Laboratory of Natural and Biomimetic Drugs, Peking University, 100191, Beijing, China

    Jie Shi

  10. The Key Laboratory for Neuroscience of the Ministry of Education and Health, Peking University, 100191, Beijing, China

    Jie Shi

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Contributions

LL, JS, S-ZA, YS and J-WZ designed the study and wrote the protocol. X-WC and J-WZ searched and fetched data. J-WZ, NZ and S-ZA conducted the statistical analysis. X-QY, T-QD, W-YL, J-HD, SL, JS and LL interpreted the results. J-WZ wrote the first draft of the manuscript. S-HC, YS, S-QM, Y-PB, J-LY, JS and LL revised the manuscript. All authors contributed to and have approved the final manuscript.

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Correspondence to Yan Sun, Lin Lu or Jie Shi.

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Competing interests

The authors declare that they do not have any conflicts of interest in this manuscript. UK Biobank has received ethical approval from the UK National Health Service’s National Research Ethics Service (ref 11/NW/0382). Individual data that support the findings of this study from the UK Biobank and NHANES are not publicly available due to their policy, but can be made available through an application with UK Biobank (https://www.ukbiobank.ac.uk/) and NHANES (https://www.cdc.gov/nchs/nhanes/index.htm/). The code of this study are available from the corresponding author upon reasonable request.

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Zheng, JW., Ai, SZ., Chang, SH. et al. Association between alcohol consumption and sleep traits: observational and mendelian randomization studies in the UK biobank. Mol Psychiatry (2024). https://doi.org/10.1038/s41380-023-02375-7

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