Can Tech Reduce Drinking and Increase Sleep for Young Adults?

Can Tech Reduce Drinking and Increase Sleep for Young Adults?

Can smart wearables and personalized coaching improve sleep and lower risky drinking patterns in young adults? A Yale-led clinical trial offers hope for tech-driven health change.

Study: portable intervention for alcohol consumption risk and sleep in young adults

In a recently published article inJama Network OpenResearchers examined the effectiveness of combining a wearable device, tailored coaching and self-monitoring on drinking and sleep outcomes in young adult drinkers.

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Young adults are at increased risk for alcohol abuse, making them a key group for prevention efforts. Digital tools, particularly wearable devices, provide engaging, accessible options for behavior change as young adults often seek anonymous and self-directed health support.

While digital alcohol interventions have shown only modest impact, the inclusion of wearables can improve outcomes, particularly through real-time feedback and encouraging self-monitoring.

Wearables have proven helpful in areas of physical health such as sleep and fitness, but their potential to change drinking behavior remains largely untested. Alcohol-sensing wearables can detect drinking via transdermal alcohol levels, but have primarily been studied in justice settings. Wrist-worn devices now offer less invasive monitoring and are suitable for broader populations.

Interventions that integrate multiple health domains, such as sleep and alcohol, hold promise. Sleep problems are often associated with heavy drinking in young adults and can contribute to poor emotional regulation and increased cravings.

Improving sleep may indirectly reduce alcohol consumption. Additionally, young adults who engage in risky alcohol drinking are typically receptive to sleep-related interventions, which may help provide awareness and motivation to change drinking behavior.

About the study

This study tested a novel digital intervention that combined personalized feedback from wearables, coaching, and daily monitoring to reduce alcohol consumption and improve sleep for young adults.

The research team recruited 120 young adults between the ages of 18 and 25 with recent severe drinking and sleep concerns. Participants were randomized into three groups in a 2:1:1 ratio.

The lead intervention group of 60 participants received wearable feedback, coaching, web-based sleep counseling, and smartphone self-monitoring. The two control groups, each consisting of 30 participants, received only web-based advice and the second received advice and self-monitoring. All participants wore sleep and alcohol biosensors for two weeks.

To be eligible for the study, participants had at least three episodes of heavy drinking in the previous two weeks and a positive score on the Alcohol Use Disorder Identification Test.

People with sleep disorders, psychiatric illness, or current alcohol/sleep treatment were excluded. Randomization was stratified by sex and handled via a secure web-based system.

The intervention group had two virtual coaching sessions in the first two weeks. In graduate student training, trainers faced motivational interviewing to discuss feedback from wearable and diary data.

Visualizations linked alcohol consumption to sleep disturbances and estimated blood alcohol concentrations during sleep. Trainers provided tailored behavioral strategies and supported goal setting.

Self-monitoring groups completed daily smartphone diaries of alcohol and sleep. The primary outcome was total drinks from weeks four to twelve. Secondary outcomes included sleep-related impairments, sleep disturbances, and alcohol-related consequences.

An exploratory outcome examining changes in the World Health Organization (WHO) assessment of drinking risk was also included. The WHO risk score ranges from 1 (the least risky drinking pattern) to 5 (the most).

Key Findings

Of the participants, 49% were men and the average age was 21 years. Individuals demonstrated high adherence to daily diaries (95%) and wearable use (at least 95%). Almost all participants completed the treatment and follow-up sessions.

For the primary outcome, all groups showed a significant decrease in total alcohol consumption over time, but there were no significant differences between intervention and control groups. Total drink decreased by 31% and 49% from week 4 to weeks 8 and 12, respectively.

For secondary outcomes, the intervention group reported significantly lower sleep disturbance compared to both control groups and with less sleep disturbance than the consultation-only control group. The effect on sleep disturbance was not significant compared to the advice and self-monitoring groups, and the effect size was small.

Alcohol-related consequences decreased over time in all groups, but there was no significant difference between the intervention and control groups for secondary outcomes.

In exploratory analyses, the intervention group was significantly more likely to reduce alcohol risk at week 4 than medium-effect advice alone. This finding was not a predetermined primary or secondary outcome.

Reductions in sleep disturbance were significantly associated with risk reduction, suggesting a possible link between improved sleep and reduced drinking risk.

Conclusions

This study found that while all participants reduced drinking over time, the digital intervention combining wearables and coaching produced modest benefits specifically for impaired sleep and alcohol risk level reduction, but not for the primary drinking outcome.

High adherence and satisfaction support the feasibility of this approach, particularly among young adults motivated by sleep improvement.

Strengths of this study include novel alcohol bug recovery, integration of multimodal data, rigorous experimental design, and minimal missing data. However, limitations include a homogeneous sample, short follow-up, limited power for small effects, and the subjective nature of the results.

The intervention demonstrates the potential for scalable health behavior change in young adults, particularly when addressing sleep and drinking together. Future studies should test longer, more diverse implementations and examine the integration of digital coaching and feedback across multiple health behaviors for broader public health implications.

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