Sleep Dysfunction in Pathological Gamblers 

 Stephanie Lin, Iman Parhami, MD, MPH, Timothy Fong, MD

 
Semel Institute for Neuroscience and Human Behavior
University of California, Los Angeles

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Objective:   This cross-sectional study examined sleep dysfunction in pathological gamblers (PGs).

Methods:  One-hundred and nine subjects (37 pathological gamblers and 72 non-pathological gamblers) participating in an ongoing gambling study were assessed for sleep dysfunction using self-administered questionnaires.  Gambling behavior was assessed using the DSM-IV checklist criteria for PG, which is a diagnosing tool and a severity scale based on the number of criteria met, and the Addiction Severity Index for Gambling, which documents gambling behavior in the last month.  Sleep dysfunction was assessed using the Epsworth Sleepiness Scale (ESS) and the Pittsburg Sleep Quality Index (PSQI). Independent-sample T-tests were performed to determine the mean difference between dependent variables for PGs compared to non-PGs.  To further investigate this relationship, Pearson correlations were done to examine the association between the number of DSM-IV criteria the subjects met for PG and various dependent variables.

Results:  PGs reported sleeping approximately 38 minutes less per day compared to non-PGs (t=2.043, df=67.289, p=.045). Additionally, PGs scored higher on the ESS (mean difference= 3.21, t= 3.664, df=65.57, p<.001) and on the PSQI (mean difference=1.18. t=1.80, df=73.09, p=0.076). Ancillary analyses demonstrated that the number of DSM-IV criteria the subjects met for PG was statistically associated with the ESS score (r=.328, p<.001) and the PSQI score (r=.264, p=.006). Furthermore, the ESS score was associated with the amount of money lost (r=.283. p=.001) and how often the participant gambled more than they could afford (r=.187, p=.025), while the PSQI was associated with total hours of gambling (r=0.230, p=0.012), and how often the participant gambled more than they could afford (r=0.284, p=0.003).

Conclusion:  According to these findings, PGs are more likely to experience sleep problems compared to non-PGs and individuals with more severe gambling problems may be at risk for increased sleep dysfunction.  More research is necessary to examine why PGs experience greater sleep dysfunction and whether treatment for sleep disorders can help reduce gambling behavior. Nevertheless, this study should increase provider awareness of sleep disorders in PGs and encourage providers to include sleep dysfunction in their assessment and plans.