Randomized trial qualitative analysis demonstrates strong sleep improvements and modest indirect alcohol benefits in heavy drinkers, suggesting adaptations could enhance dual-target outcomes.
Digital cognitive behavioral therapy for insomnia (d-CBT-I) shows promise for improving sleep and reducing drinking among heavy drinkers with comorbid insomnia, a population characterized by a bidirectional relationship between alcohol use and sleep disturbance. This qualitative study examined experiences of a subgroup of heavy drinkers with insomnia who completed SHUTi, a well-validated d-CBT-I program, as part of two sequential randomized controlled trials (NCT04564807; NCT05630118). Semi-structured post-intervention interviews of SHUTi completers ( n = 46) were analyzed using Braun and Clarke’s reflexive thematic analysis. Four themes emerged: overall impressions; advantages and disadvantages for sleep; advantages and disadvantages for alcohol use; and suggested program improvements. SHUTi was perceived as highly beneficial for sleep. Perceived alcohol benefits were modest and indirect, suggesting that the alcohol benefit is best understood as a clinically important hypothesis about alcohol use mediated by changes in insomnia severity as well as a rationale for future SHUTi adaptations to better support alcohol reduction. Trial Registration : ClinicalTrials.gov Identifiers: NCT04564807 (Registered 09-22-2020) and NCT05630118 (Registered 11-17-2022).
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Moloney et al. (2026) studied this question.
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