Answer C. Sleep latency
Foster et al1 queried alcohol-dependent subjects in an inpatient setting and found a subjective sense of sleep latency to be a predictor of relapse. Other studies also support this association between subjective perceptions of increased awakenings and difficulty falling asleep and relapse risk in early alcohol recovery.
Objective evidence of sleep disturbance exists in alcohol use disorders as well. Polysomnography studies suggest that chronic alcohol use increases sleep latency (defined as the amount of time from lights out to sleep onset) throughout the vacillating stages of use, including active drinking periods, acute withdrawal, post-withdrawal, and early and late recovery.
In their review, Angarita and colleagues2 conclude that total sleep time (the amount of sleep in one complete episode of sleeping) is uniformly adversely affected by alcohol in all of its use stages from active drinking to later recovery.
1. Foster JH, Peters TJ. Impaired sleep in alcohol misusers and dependent alcoholics and the impact upon outcome. Alcohol Clin Exp Res. 1999;23:1044-1051.
2. Angarita GA, Emadi N, Hodges S, Morgan PT. Sleep abnormalities associated with alcohol, cannabis, cocaine, and opiate use: a comprehensive review. Addict Sci Clin Pract. 2016;11:9.
For more on this topic, see Understanding and Addressing Sleep Disruptions in Alcohol Use Disorders, on which this quiz is based.