metricas
covid
Buscar en
European Journal of Psychiatry
Toda la web
Inicio European Journal of Psychiatry Sleep features in alcohol use disorder: A systematic review and meta-analysis of...
Journal Information

Statistics

Follow this link to access the full text of the article

Original article
Sleep features in alcohol use disorder: A systematic review and meta-analysis of polysomnographic findings in case-control studies
Pingyuan Yang, Jiajun Weng, Xiao Huang
Corresponding author
huang.xiao@zs-hospital.sh.cn

Corresponding author.
Department of Psychological Medicine, Zhongshan Hospital, Fudan University, Shanghai, China
Read
Not available
Times
was read the article
Total PDF
Total HTML
Share statistics
 array:22 [
  "pii" => "S0213616323000447"
  "issn" => "02136163"
  "doi" => "10.1016/j.ejpsy.2023.100231"
  "estado" => "S300"
  "fechaPublicacion" => "2024-04-01"
  "aid" => "100231"
  "copyrightAnyo" => "2023"
  "documento" => "article"
  "crossmark" => 1
  "subdocumento" => "fla"
  "cita" => "Eur J Psychiatry. 2024;38:"
  "abierto" => array:3 [
    "ES" => false
    "ES2" => false
    "LATM" => false
  ]
  "gratuito" => false
  "lecturas" => array:1 [
    "total" => 0
  ]
  "itemSiguiente" => array:18 [
    "pii" => "S0213616323000423"
    "issn" => "02136163"
    "doi" => "10.1016/j.ejpsy.2023.100229"
    "estado" => "S300"
    "fechaPublicacion" => "2024-04-01"
    "aid" => "100229"
    "copyright" => "Sociedad Española de Psiquiatría y Salud Mental"
    "documento" => "article"
    "crossmark" => 1
    "subdocumento" => "fla"
    "cita" => "Eur J Psychiatry. 2024;38:"
    "abierto" => array:3 [
      "ES" => false
      "ES2" => false
      "LATM" => false
    ]
    "gratuito" => false
    "lecturas" => array:1 [
      "total" => 0
    ]
    "en" => array:10 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Original article</span>"
      "titulo" => "Effects of antipsychotics on amino acid levels in patients with first-episode schizophrenia&#58; A prospective study"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "tieneResumen" => "en"
      "contieneResumen" => array:1 [
        "en" => true
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "X&#46; Wang, L&#46; Wang, Y&#46; Xue, Y&#46; Li"
          "autores" => array:4 [
            0 => array:2 [
              "nombre" => "X&#46;"
              "apellidos" => "Wang"
            ]
            1 => array:2 [
              "nombre" => "L&#46;"
              "apellidos" => "Wang"
            ]
            2 => array:2 [
              "nombre" => "Y&#46;"
              "apellidos" => "Xue"
            ]
            3 => array:2 [
              "nombre" => "Y&#46;"
              "apellidos" => "Li"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0213616323000423?idApp=UINPBA00004N"
    "url" => "/02136163/0000003800000002/v1_202403290827/S0213616323000423/v1_202403290827/en/main.assets"
  ]
  "itemAnterior" => array:18 [
    "pii" => "S0213616323000472"
    "issn" => "02136163"
    "doi" => "10.1016/j.ejpsy.2023.100234"
    "estado" => "S300"
    "fechaPublicacion" => "2024-04-01"
    "aid" => "100234"
    "copyright" => "Sociedad Espa&#241;ola de Psiquiatr&#237;a y Salud Mental"
    "documento" => "article"
    "crossmark" => 1
    "subdocumento" => "fla"
    "cita" => "Eur J Psychiatry. 2024;38:"
    "abierto" => array:3 [
      "ES" => false
      "ES2" => false
      "LATM" => false
    ]
    "gratuito" => false
    "lecturas" => array:1 [
      "total" => 0
    ]
    "en" => array:11 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Original article</span>"
      "titulo" => "Predictors of transition to schizophrenia and other long-lasting non-affective psychoses in first-episode patients with acute and transient psychotic disorders&#58; A validation study"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "tieneResumen" => "en"
      "contieneResumen" => array:1 [
        "en" => true
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:8 [
          "identificador" => "fig0001"
          "etiqueta" => "Fig&#46; 1"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr1.jpeg"
              "Alto" => 1984
              "Ancho" => 2917
              "Tamanyo" => 417656
            ]
          ]
          "detalles" => array:1 [
            0 => array:3 [
              "identificador" => "alt0004"
              "detalle" => "Fig "
              "rol" => "short"
            ]
          ]
          "descripcion" => array:1 [
            "en" => "<p id="spara001" class="elsevierStyleSimplePara elsevierViewall">Diagnostic trajectories of patients with first-episode acute and transient psychotic disorder &#40;ATPD&#41; during a two-year follow-up period&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "&#193;lvaro L&#243;pez-D&#237;az, Jos&#233; Luis Fern&#225;ndez-Gonz&#225;lez, Ignacio Lara, Benedicto Crespo-Facorro, Miguel Ruiz-Veguilla"
          "autores" => array:5 [
            0 => array:2 [
              "nombre" => "&#193;lvaro"
              "apellidos" => "L&#243;pez-D&#237;az"
            ]
            1 => array:2 [
              "nombre" => "Jos&#233; Luis"
              "apellidos" => "Fern&#225;ndez-Gonz&#225;lez"
            ]
            2 => array:2 [
              "nombre" => "Ignacio"
              "apellidos" => "Lara"
            ]
            3 => array:2 [
              "nombre" => "Benedicto"
              "apellidos" => "Crespo-Facorro"
            ]
            4 => array:2 [
              "nombre" => "Miguel"
              "apellidos" => "Ruiz-Veguilla"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0213616323000472?idApp=UINPBA00004N"
    "url" => "/02136163/0000003800000002/v1_202403290827/S0213616323000472/v1_202403290827/en/main.assets"
  ]
  "en" => array:19 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Original article</span>"
    "titulo" => "Sleep features in alcohol use disorder&#58; A systematic review and meta-analysis of polysomnographic findings in case-control studies"
    "tieneTextoCompleto" => true
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "Pingyuan Yang, Jiajun Weng, Xiao Huang"
        "autores" => array:3 [
          0 => array:2 [
            "nombre" => "Pingyuan"
            "apellidos" => "Yang"
          ]
          1 => array:2 [
            "nombre" => "Jiajun"
            "apellidos" => "Weng"
          ]
          2 => array:4 [
            "nombre" => "Xiao"
            "apellidos" => "Huang"
            "email" => array:1 [
              0 => "huang.xiao@zs-hospital.sh.cn"
            ]
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">&#42;</span>"
                "identificador" => "cor0001"
              ]
            ]
          ]
        ]
        "afiliaciones" => array:1 [
          0 => array:2 [
            "entidad" => "Department of Psychological Medicine&#44; Zhongshan Hospital&#44; Fudan University&#44; Shanghai&#44; China"
            "identificador" => "aff0001"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor0001"
            "etiqueta" => "&#8270;"
            "correspondencia" => "Corresponding author&#46;"
          ]
        ]
      ]
    ]
    "resumenGrafico" => array:2 [
      "original" => 0
      "multimedia" => array:8 [
        "identificador" => "fig0004"
        "etiqueta" => "Fig&#46; 4"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr4.jpeg"
            "Alto" => 1481
            "Ancho" => 3500
            "Tamanyo" => 130110
          ]
        ]
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "alt0006"
            "detalle" => "Fig "
            "rol" => "short"
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spara004" class="elsevierStyleSimplePara elsevierViewall">Funnel plots describing the spread of studies on the features of sleep macroarchitecture&#46; Features of sleep macroarchitecture include &#40;A&#41; total sleep time&#44; &#40;B&#41; sleep onset latency&#44; &#40;C&#41; sleep efficiency&#44; &#40;D&#41; wake after sleep onset&#44; &#40;E&#41; stage 1&#44; &#40;F&#41; stage 2&#44; &#40;G&#41; slow wave sleep&#44; &#40;H&#41; rapid eye movement sleep&#44; &#40;I&#41; rapid eye movement sleep latency&#44; &#40;J&#41; rapid eye movement sleep latency&#44; &#40;K&#41; 1st rapid eye movement sleep minutes&#46; Asymmetry in funnel plots represents publication bias&#46;</p>"
        ]
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0001" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cesectitle0007">Introduction</span><p id="para0005" class="elsevierStylePara elsevierViewall">Alcohol is one of the most commonly used psychoactive substances worldwide&#46; Reportedly&#44; about 50&#37; of adult respondents consume alcohol&#44; of whome some indulge in heavy drinking&#46;<a class="elsevierStyleCrossRef" href="#bib0001"><span class="elsevierStyleSup">1</span></a> The heavy drinking pattern is prevalent among individuals suffering from alcohol use disorder &#40;AUD&#41; or alcohol dependence disorder &#40;AD&#41;&#44; which is linked to a higher incidence of medical and mental health conditions characterized by sleep disturbance&#46;<a class="elsevierStyleCrossRef" href="#bib0002"><span class="elsevierStyleSup">2</span></a></p><p id="para0006" class="elsevierStylePara elsevierViewall">According to the Rechtschaffen and Kales &#40;R&#38;K&#41; standardized scoring system described in 1968&#44; sleep is comprised of two states&#58; rapid eye movement &#40;REM&#41; and non-REM sleep &#40;NREM&#41;&#44; which can be further dissected into four stages &#40;S1&#8211;4&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0003"><span class="elsevierStyleSup">3</span></a> S1&#44; the lightest stage and always considered a measure of sleep quality&#44; is commonly known as light NREM sleep &#40;N1&#41;&#46; During this stage&#44; individuals experience fluctuations in consciousness&#46; S2&#44; also referred to as N2&#44; is a distinct sleep stage characterized by the presence of sleep spindles and K-complexes&#46; This stage makes up approximately 45&#8211;55&#37; of the sleep cycle&#46; S3 and S4&#44; collectively known as slow wave sleep &#40;SWS&#41; or N3&#44; represent a phase of deep restorative sleep&#46; Sleep typically starts with N1 and progresses towards deeper stages of NREM until the first period of REM sleep is reached&#46; Afterwards&#44; REM and NREM sleep alternate in cycles lasting about 90 min&#46; The states of sleep are regulated by homeostasis&#44; meaning that a lack of REM or SWS triggers a need to enter that stage&#44; and once it begins&#44; there is an increased intensity of that stage to compensate for the deprivation&#46;</p><p id="para0007" class="elsevierStylePara elsevierViewall">Among patients with AUD&#44; the rate of sleep disturbance is higher than that in the general population&#46;<a class="elsevierStyleCrossRef" href="#bib0004"><span class="elsevierStyleSup">4</span></a> The correlation between sleep disturbance and AUD is bidirectional&#46; Alcohol is often used as a sleep aid&#44; and it can have either a stimulating or sedating effect&#44; inducing sleep&#46;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">5</span></a><a class="elsevierStyleCrossRef" href="#bib0006"><span class="elsevierStyleSup">6</span></a> Stimulating effects are commonly observed at lower doses as blood alcohol levels increase&#44; typically within the first hour following consumption&#46; Conversely&#44; sedating effects manifest at higher doses and as blood alcohol levels gradually decrease&#46; Instead of seeking professional treatment&#44; many adolescents and adults suffering from insomnia often resort to using alcohol as a means to induce sleep&#44; only to experience adverse effects and unintentionally worsen their condition&#46;<a class="elsevierStyleCrossRef" href="#bib0007"><span class="elsevierStyleSup">7</span></a> Mounting evidence suggests that alcohol consumption significantly disrupts sleep patterns&#44; particularly by affecting REM&#44; SWS as well as sleep duration&#44; latency&#44; and continuity&#46;<a class="elsevierStyleCrossRef" href="#bib0008"><span class="elsevierStyleSup">8</span></a> The net effect of an intoxicating alcohol dose is to worsen sleep by increasing awakeness after sleep onset &#40;WASO&#41; and reducing sleep onset latency &#40;SOL&#41;&#46;<a class="elsevierStyleCrossRefs" href="#bib0009"><span class="elsevierStyleSup">9-11</span></a> Therefore&#44; the persistent use of alcohol can be deemed a counterproductive long-term approach&#44; as it not only hampers the quality of sleep but also exacerbates the urge to consume excessive amounts of alcohol&#46; Furthermore&#44; individuals who are dependent on alcohol commonly encounter sleep difficulties not only while actively drinking but also during different phases of abstinence&#44; such as acute&#44; subacute&#44; or chronic periods&#46;<a class="elsevierStyleCrossRefs" href="#bib0012"><span class="elsevierStyleSup">12-14</span></a> Consequently&#44; increasing clinical awareness of sleep problems as a symptom of AUD can potentially enable prompt intervention and timely treatment&#46;</p><p id="para0008" class="elsevierStylePara elsevierViewall">Polysomnography &#40;PSG&#41; is an objective method to derive quantitative sleep measures and record electroencephalogram&#44; electrooculogram&#44; and electromyogram&#46; PSG can provide detailed examination of sleep macroarchitecture&#44; which refers to the latencies and durations of sleep stages&#46;<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">15</span></a> To date&#44; numerous studies have used PSG to understand the neurobiology of AUD&#46; Using PSG&#44; these studies have documented sleep disturbances in individuals with AUD compared to healthy controls&#44; which include abnormalities in TST&#44; sleep onset latency &#40;SOL&#41;&#44; sleep efficiency &#40;SE&#41;&#44; S1&#44; SWS&#44; REM sleep&#44; REM sleep latency &#40;REML&#41;&#44; and REM sleep density &#40;REMD&#41;&#46;<a class="elsevierStyleCrossRefs" href="#bib0016"><span class="elsevierStyleSup">16-18</span></a> It is worth mentioning that a number of past studies have relied on subjective self-report measures to define &#34;sleep problems&#34; but did not find a significant association between alcohol use and insomnia&#46;<a class="elsevierStyleCrossRef" href="#bib0019"><span class="elsevierStyleSup">19</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">20</span></a> As a result&#44; there is a need for a comprehensive analysis of objective sleep measures in order to provide a more accurate understanding of the relationship between alcohol use and sleep disturbances&#46;</p><p id="para0009" class="elsevierStylePara elsevierViewall">The present study aimed to examine the comprehensive pattern of objectively measured sleep abnormalities in individuals with AUD by synthesizing previous relevant research findings&#46; In addition&#44; moderator analysis was used to identify potential variables that could influence the sleep features of AUD&#46; We hypothesized that individuals with AUD would exhibit impaired sleep continuity and PSG characteristics compared to healthy controls&#44; with variations in clinical and methodological factors moderating the heterogeneity observed among the studies&#46;</p></span><span id="sec0002" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cesectitle0008">Methods</span><span id="sec0003" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cesectitle0009">Design and registration</span><p id="para0010" class="elsevierStylePara elsevierViewall">This review was conducted according to the registered protocol PROSPERO CRD42022344827 &#40;https&#58;&#47;&#47;www&#46;crd&#46;york&#46;ac&#46;uk&#47;PROSPERO&#47;&#41; and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses &#40;PRISMA&#41; statement&#46;<a class="elsevierStyleCrossRef" href="#bib0021"><span class="elsevierStyleSup">21</span></a></p></span><span id="sec0004" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cesectitle0010">Inclusion and exclusion criteria</span><p id="para0011" class="elsevierStylePara elsevierViewall">The inclusion criteria for this meta-analysis were as follows&#58; &#40;1&#41; Participants&#58; individuals with AUD&#44; alcohol abusers&#44; or chronic heavy alcohol users&#59; &#40;2&#41; Intervention&#58; sleep parameters were assessed using PSG&#59; &#40;3&#41; Comparison groups&#58; a non-using or limited use group&#59; &#40;4&#41; Outcomes&#58; means and standard deviations of TST&#44; SOL&#44; SE&#44; WASO&#44; S1&#47;N1&#44; S2&#47;N2&#44; SWS&#47;N3&#44; REM&#44; REML&#44; REMD&#44; and 1st REM min&#59; &#40;5&#41; Type of studies&#58; case-control studies conducted in English&#46;</p><p id="para0012" class="elsevierStylePara elsevierViewall">The exclusion criteria were as follows&#58; &#40;1&#41; participants with any other severe neurological or mental disorders listed in the Diagnostic and Statistical Manual of Mental Disorders Fourth Edition &#40;DSM-IV&#41;&#59; &#40;2&#41; studies conducted on animals&#59; &#40;3&#41; studies that did not use the R&#38;K or the American Academy of Sleep Medicine &#40;AASM&#41; criteria for PSG scoring&#59; &#40;4&#41; studies that duplicated previous publication&#40;s&#41;&#59; &#40;5&#41; studies in which essential data were unavailable from the corresponding author through email&#46; The inclusion of the studies was determined by two independent investigators&#44; and any disputes were resolved through discussion&#46;</p></span><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cesectitle0011">Search strategies</span><p id="para0013" class="elsevierStylePara elsevierViewall">A literature search was conducted on PubMed&#44; Embase&#44; Web of Science&#44; MedLine&#44; CINAHL&#44; PsycINFO&#44; and Cochrane from 1968 to 2023&#44; without any date restrictions&#46; The following keywords were used&#58; &#40;&#8220;alcohol&#8221; OR &#8220;ethanol abuse&#8221; OR &#8220;alcoholism&#8221; OR &#8220;alcohol dependence&#8221; OR &#8220;alcohol addiction&#8221; OR &#8220;alcohol abuse&#8221; OR &#8220;alcohol use disorder&#8221;&#41; AND &#40;&#8220;sleep&#8221; OR &#8220;sleep disturbance&#8221; OR &#8220;polysomnography&#8221; OR &#8220;PSG&#8221; OR &#8220;REM&#8221; OR &#8220;slow wave sleep&#8221; OR &#8220;slow wave activity&#8221; OR &#8220;NREM sleep&#8221; OR &#8220;delta sleep&#8221; OR &#8220;sleep macroarchitecture&#8221;&#41;&#46; The final literature searches were conducted in May 2023&#46; The retrieved studies were then reviewed and duplicates were removed&#46; Inclusion and exclusion criteria were applied to select appropriate articles&#46; The titles&#44; abstracts&#44; keywords&#44; and full texts of the retrieved studies were reviewed to exclude irrelevant articles&#46; Additionally&#44; the reference lists of the retrieved studies and recent reviews were manually checked to identify any additional studies that met the inclusion criteria&#46;</p></span><span id="sec0006" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cesectitle0012">Quality assessment</span><p id="para0014" class="elsevierStylePara elsevierViewall">Included studies were assessed for methodological quality and the putative risk of bias using the validated Newcastle-Ottawa Scale &#40;NOS&#41;&#44; which evaluates the non-randomized trials consisting of cohort and case-control studies&#46;<a class="elsevierStyleCrossRef" href="#bib0022"><span class="elsevierStyleSup">22</span></a></p></span><span id="sec0007" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cesectitle0013">Data extraction</span><p id="para0015" class="elsevierStylePara elsevierViewall">The following demographic information was obtained from eligible studies in this meta-analysis&#58; the first author&#39;s name&#44; publication year&#44; number of participants&#44; number of male participants&#44; mean age&#44; ethnicity&#44; and years of education&#46; The illness-related information included diagnostic tools&#44; length of dependence&#44; duration of abstinence&#44; drinks per day&#44; and drinking days per month&#46; Mean effect measures and their standard deviation were then extracted&#44; including TST&#44; SOL&#44; SE&#44; WASO&#44; REML&#44; REMD&#44; 1st REM min&#44; and the proportion of S1&#44; S2&#44; SWS&#44; and REM&#46; Two independent reviewers extracted the data and any discrepancies in the results were resolved through discussion&#46; A third independent reviewer assessed the coding for accuracy by randomly selecting and recoding five articles and examining potential outliers in the data&#46; In cases of missing data&#44; corresponding authors were contacted via email&#46; If no feedback was received&#44; studies with missing information were excluded&#46;</p></span><span id="sec0008" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cesectitle0014">Data analysis</span><p id="para0016" class="elsevierStylePara elsevierViewall">For each measure&#44; we calculated Cohen&#39;s <span class="elsevierStyleItalic">d</span> in accordance with the standard systematic approach on the platform &#40;http&#58;&#47;&#47;www&#46;campbellcollaboration&#46;org&#47;resources&#47;effect-size-input&#46;php&#41;&#44; using means and standard deviations or standard errors whenever feasible&#46; Occasionally&#44; F&#44; t&#44; or p-values were used along with the sample size to estimate the effect size&#46; The magnitude of the difference between groups was expressed using hen&#39;s <span class="elsevierStyleItalic">d</span> which is a measure of effect size&#46; This parameter indicates the extent to which the dependent variable is present in the sample group or the extent to which the null hypothesis is false&#46; Due to the expected variability resulting from demographic characteristics and inclusion and exclusion criteria&#44; we employed the random effects model to determine the overall effect size&#46; To address the issue of overestimating the effect size associated with small sample sizes&#44; <span class="elsevierStyleItalic">Hedge&#39;s correction</span> was applied to each effect size&#46; Additionally&#44; the inverse variance weights for each study were calculated using the corrected effect size&#46;<a class="elsevierStyleCrossRef" href="#bib0023"><span class="elsevierStyleSup">23</span></a></p><p id="para0017" class="elsevierStylePara elsevierViewall">Heterogeneity was tested using Cochran&#39;s Q test and I2 statistic&#46;<a class="elsevierStyleCrossRef" href="#bib0024"><span class="elsevierStyleSup">24</span></a> A significant Q indicated substantial differences between the studies contributing to the pooled effect size&#46; I2 was used as a second measure of heterogeneity of effect size representing within-study heterogeneity expressed as a percentage of the total variation across studies&#46; In this study&#44; we considered lack of statistical heterogeneity for 0&#8804;I2&#60;25&#37;&#44; low for 25&#37;&#8804;I2&#60;50&#37;&#44; moderate for 50&#37;&#8804;I2&#60;75&#37;&#44; and high for 75&#37;&#8804;I2&#46; The publication bias was checked using the funnel plot and Egger&#39;s tests&#46;<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">25</span></a> Sensitivity analysis was conducted using the leave-one-out method to examine the influence of each study on the synthesized effect size in the random effects model&#46;<a class="elsevierStyleCrossRef" href="#bib0026"><span class="elsevierStyleSup">26</span></a></p><p id="para0018" class="elsevierStylePara elsevierViewall">After calculating the overall effect size&#44; Hedge&#39;s <span class="elsevierStyleItalic">g</span> was computed as the effect size for the moderator analysis&#44; which included both categorical and continuous moderators&#46;<a class="elsevierStyleCrossRef" href="#bib0027"><span class="elsevierStyleSup">27</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRef" href="#bib0028"><span class="elsevierStyleSup">28</span></a> The planned subgroup analysis for categorical moderators included the following pre-defined categories&#58; ethnicity &#40;African&#44; European&#44; and Mixed&#41;&#44;<a class="elsevierStyleCrossRef" href="#bib0029"><span class="elsevierStyleSup">29</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">30</span></a> age &#40;&#60; 40&#44; &#62; 40&#41;&#44;<a class="elsevierStyleCrossRef" href="#bib0031"><span class="elsevierStyleSup">31</span></a> sample size &#40;small &#60; 40&#44; large &#8805; 40&#41;&#44; gender composition &#40;male&#44; mixed&#44; and female&#41;&#44; diagnostic system &#40;DSM-IV&#44; DSM-III-R&#44; and others&#41; and duration of abstinence &#40;short-abstinence period &#8804; 1 month and long-abstinence period &#62; 1 month&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0032"><span class="elsevierStyleSup">32</span></a> On the other hand&#44; meta-regression analysis was used to examine whether the pre-defined quantitative moderators could influence the effect size&#46; These included education years&#44; length of dependence&#44; drinks per day&#44; and drinking days per month&#46; To ensure that all participants fell within the range of the moderators&#44; the distribution was examined rather than just the mean&#46; All statistical analyses were performed using the R package &#34;meta&#34;&#46;</p></span><span id="sec0009" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cesectitle0015">Assessment of cumulative evidence</span><p id="para0019" class="elsevierStylePara elsevierViewall">The quality of evidence for each outcome across studies was evaluated using four levels of confidence &#40;high&#44; moderate&#44; low&#44; or very low confidence&#41; according to the Grades of Recommendations&#44; Assessment&#44; Development&#44; and Evaluation &#40;GRADE&#41; criteria&#46;<a class="elsevierStyleCrossRef" href="#bib0033"><span class="elsevierStyleSup">33</span></a></p></span></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cesectitle0016">Results</span><span id="sec0011" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cesectitle0017">Characteristics of included studies</span><p id="para0020" class="elsevierStylePara elsevierViewall">A total of 13 datasets from 12 studies that met the inclusion criteria were included in this meta-analysis&#46;<a class="elsevierStyleCrossRefs" href="#bib0016"><span class="elsevierStyleSup">16-18</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRefs" href="#bib0034"><span class="elsevierStyleSup">34-42</span></a> The study by Irwin et al&#46; &#40;2000&#41; consisted of two case groups&#46;<a class="elsevierStyleCrossRef" href="#bib0034"><span class="elsevierStyleSup">34</span></a> A summary of the screening process is presented in <a class="elsevierStyleCrossRef" href="#fig0001">Fig&#46; 1</a>&#46; The cohort comprised 359 patients with AUD &#40;283 males&#47;76 females&#41; and 714 healthy controls &#40;286 males&#47;428 females&#41;&#46; Other demographic and clinical information for each study is presented in <a class="elsevierStyleCrossRef" href="#tbl0001">Table 1</a>&#46; In addition&#44; the methodological quality of the studies assessed by NOS is summarized in the Supplementary materials&#46; Most of the included studies were scored &#8805; 6 stars&#44; and hence rated high quality&#46;</p><elsevierMultimedia ident="fig0001"></elsevierMultimedia><elsevierMultimedia ident="tbl0001"></elsevierMultimedia></span><span id="sec0012" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cesectitle0018">Overall effect size and heterogeneity analysis</span><p id="para0021" class="elsevierStylePara elsevierViewall">Due to moderate heterogeneity&#44; we used the random-effects model to synthesize the pooled effect size&#46; Patients with AUD exhibited several sleep-related alterations compared to non-dependent individuals&#46; They experienced decreased TST&#44; increased SOL&#44; decreased SE&#44; increased S1&#37;&#44; decreased S2&#37;&#44; decreased SWS&#37;&#44; increased REMD&#44; and increased 1st REM min&#46; Significant heterogeneity was noted in all results except for WASO&#37;&#44; REM&#37;&#44; and REML&#46; To provide specific details concerning the pooled effect sizes and heterogeneity&#44; please refer to <a class="elsevierStyleCrossRef" href="#tbl0002">Table 2</a> and <a class="elsevierStyleCrossRef" href="#fig0002">Fig&#46; 2</a>&#46;</p><elsevierMultimedia ident="tbl0002"></elsevierMultimedia><elsevierMultimedia ident="fig0002"></elsevierMultimedia><p id="para0022" class="elsevierStylePara elsevierViewall">To evaluate the influence of outliers&#44; we examined the standardized residual across all studies&#46; Furthermore&#44; we performed a sensitivity analysis by systematically removing one study at a time to assess the impact of individual studies on the pooled SMDs&#46; The results revealed a reduction in heterogeneity for TST &#40;I2&#61;33&#46;5&#41;&#44; SOL &#40;I2&#61;44&#46;0&#41;&#44; SE&#37; &#40;I2&#61;37&#46;4&#41;&#44; WASO &#40;I2&#61;43&#46;7&#41;&#44; N1&#37; &#40;I2&#61;61&#46;7&#41;&#44; N2&#37; &#40;I2&#61;31&#46;5&#41;&#44; SWS&#37; &#40;I2&#61;43&#46;2&#41;&#44; REM&#37; &#40;I2&#61;48&#46;7&#41;&#44; REMD &#40;I2&#61;61&#46;9&#41;&#44; and 1st REM min &#40;I2&#61;0&#41; after excluding the study conducted by Irwin et al&#46; &#40;2016&#41;&#46; However&#44; even after removing the outlying study&#44; the effect sizes for SOL &#40;p&#60;0&#46;001&#41;&#44; SE&#37; &#40;p&#60;0&#46;001&#41;&#44; N1&#37; &#40;p&#60;0&#46;001&#41;&#44; N2&#37; &#40;p&#60;0&#46;05&#41;&#44; SWS&#37; &#40;p&#60;0&#46;001&#41;&#44; REMD &#40;p&#60;0&#46;001&#41;&#44; and 1st REM min &#40;p&#60;0&#46;001&#41; remained significant&#46; In contrast&#44; the results for TST and REM&#37; exhibited inconsistency&#46; The detailed results are referred to in <a class="elsevierStyleCrossRef" href="#fig0003">Fig&#46; 3</a>&#46;</p><elsevierMultimedia ident="fig0003"></elsevierMultimedia><p id="para0023" class="elsevierStylePara elsevierViewall">Funnel plots&#44; Begg&#39;s test&#44; and Egger&#39;s test were used to reveal the possible publication bias&#46; The results indicate that there is no overestimation of the parameters &#40;<a class="elsevierStyleCrossRef" href="#tbl0002">Table 2</a> and <a class="elsevierStyleCrossRef" href="#fig0004">Fig&#46; 4</a>&#41;&#46;</p><elsevierMultimedia ident="fig0004"></elsevierMultimedia><p id="para0024" class="elsevierStylePara elsevierViewall">Despite their high methodological quality&#44; direct evidence&#44; and precision&#44; the studies included in the analysis exhibited moderate heterogeneity&#46; As a result&#44; the existing evidence to comprehend the sleep characteristics in AUD was deemed of very low quality based on the GRADE rating system &#40;see Supplement materials&#41;&#46;</p></span><span id="sec0013" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cesectitle0019">Moderator analysis</span><p id="para0025" class="elsevierStylePara elsevierViewall">In the subgroup analysis of ethnicity&#44; it was found that African patients with AUD exhibited increased SOL&#44; decreased SWS&#37;&#44; and increased REM&#37; compared to healthy controls&#46; On the other hand&#44; European patients showed decreased SE&#44; increased WASO&#44; decreased SWS&#44; decreased REML&#44; and increased REMD in comparison to the healthy controls&#46; Regarding age-based subgroup analysis&#44; younger patients showed an increase in SOL and REM&#37; while experience a decrease in SWS&#37;&#46; On the other hand&#44; older patients exhibited an increase in WASO and S1&#37; along with a decrease in SE&#44; S2&#37; and SWS&#46; In the subgroup analysis based on sample size&#44; we observed that studies with smaller sample sizes showed higher S1&#37;&#44; lower SWS&#37;&#44; higher REM&#37;&#44; longer REMD&#44; and longer 1st REM min&#46; Conversely&#44; studies with larger sample sizes recorded lower&#46; When considering the subgroup analysis according to DSM-IV criteria&#44; it was found that patients exhibited increased SOL&#44; WASO&#44; and 1st REM min but decreased S2&#37; and SWS&#37;&#46; Male patients had shorter TST&#44; longer SOL&#44; lower SE&#37;&#44; higher S1&#37;&#44; lower S2&#37;&#44; lower SWS&#37;&#44; higher REM&#37;&#44; longer REMD&#44; and longer 1st REM min compared to female patients&#46; In the subgroup analysis based on the duration of abstinence&#44; patients with a long abstinence period had higher S1&#37;&#44; lower SWS&#37;&#44; and higher REM&#37;&#44; while patients with a short abstinence period had shorter TST&#44; longer SOL&#44; lower SE&#37;&#44; higher S1&#37;&#44; lower S2&#37;&#44; lower SWS&#37;&#44; and shorter REML&#46; According to the meta-regression results&#44; the effect size remained unaffected by the pre-defined moderators&#46; These findings are presented in the Supplementary materials&#46;</p></span></span><span id="sec0014" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cesectitle0020">Discussion</span><p id="para0026" class="elsevierStylePara elsevierViewall">The present study&#44; which is the first meta-analysis of polysomnographic studies&#44; examines the differences in sleep architecture between individuals with and without AUD&#46; In total&#44; 13 datasets were analyzed to investigate the effects of AUD on 11 sleep parameters&#44; including TST&#44; SOL&#44; SE&#44; WASO&#37;&#44; S1&#37;&#44; S2&#37;&#44; SWS&#37;&#44; REM&#37;&#44; REML&#44; REMD&#44; and 1st REM min&#46; In addition&#44; preliminary comparisons were conducted for six potential categorical moderators&#44; namely ethnicity&#44; age&#44; sample size&#44; gender composition&#44; diagnostic tools&#44; and duration of abstinence&#46; In terms of each sleep parameter&#44; the overall mean effect sizes indicated that individuals with AUD exhibited higher levels of N1 sleep but lower levels of N2 and SWS sleep in comparison to healthy controls&#46; Moreover&#44; patients with AUD had greater SOL&#44; REMD&#44; and 1st REM min but shorter TST and SE&#46; The high coexistence of insomnia and AUD may be due to unfavorable sleep habits and irregular sleep-wake schedules that inevitably arise from drinking&#46;<a class="elsevierStyleCrossRef" href="#bib0043"><span class="elsevierStyleSup">43</span></a> Changes in brain structure&#44; function&#44; and neurochemistry may also play a pivotal role in the aforementioned comorbidities&#46;<a class="elsevierStyleCrossRef" href="#bib0044"><span class="elsevierStyleSup">44</span></a> Strikingly&#44; the occurrence of insomnia in individuals with AUD has been reported to be approximately 91&#37;&#46;<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">45</span></a> Additionally&#44; these individuals often experience poor SE and reduced SWS&#46;On the other hand&#44; they have elevated SOL&#44; WASO&#44; and stage N1 sleep&#46; It has also been observed that abstinent AUD patients exhibit a rebound in REM sleep&#46;<a class="elsevierStyleCrossRef" href="#bib0014"><span class="elsevierStyleSup">14</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRefs" href="#bib0046"><span class="elsevierStyleSup">46-48</span></a> Furthermore&#44; the sleep disturbance of patients with AUD during the recovery period persists for several months to years following the last instance of alcohol use&#44; and gradually improves over time&#46;<a class="elsevierStyleCrossRef" href="#bib0049"><span class="elsevierStyleSup">49</span></a> Therefore&#44; previous findings partially support our results of centrally measured hyperarousal during sleep in patients with AUD&#46;</p><p id="para0027" class="elsevierStylePara elsevierViewall">Ethnicity is a significant factor associated with AUD&#46; The prevalence of alcohol use in adults is higher among Caucasians than among African-Americans&#46;<a class="elsevierStyleCrossRef" href="#bib0001"><span class="elsevierStyleSup">1</span></a> Caucasians are inherently at a higher risk than African-Americans for developing AUD throughout their lives&#44; according to research&#46;<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">50</span></a> However&#44; once alcohol dependence occurs&#44; African-Americans have a higher prevalence than Caucasians of recurrent or persistent alcohol dependence in their native population&#46;<a class="elsevierStyleCrossRef" href="#bib0051"><span class="elsevierStyleSup">51</span></a> African-American adult drinkers are disproportionately more likely to report symptoms of alcohol dependence and experience social consequences as a result of their drinking compared to Caucasian drinkers&#46;<a class="elsevierStyleCrossRef" href="#bib0052"><span class="elsevierStyleSup">52</span></a> The ethnic disparities in alcohol problems can be attributed to social and cultural factors&#46; According to reports&#44; both individual and neighborhood level economic disadvantage have been found to predict lower rates of alcohol treatment completion and higher alcohol consumption among Blacks compared to Whites&#46; The ethnic discrimination against African-Americans is linked to significant severity of AUD in the USA&#44; regardless of their specific ethnic group affiliation or poverty status&#46;<a class="elsevierStyleCrossRef" href="#bib0053"><span class="elsevierStyleSup">53</span></a> Previous studies have suggested that sleep-disordered breathing and insomnia may be more prevalent and severe among African-Americans compared to Caucasians&#46;<a class="elsevierStyleCrossRef" href="#bib0054"><span class="elsevierStyleSup">54</span></a> However&#44; the results of a meta-analysis indicated that African-Americans took longer to fall asleep and had lighter sleep with more N2 and less SWS in comparison to Caucasians&#46;<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">55</span></a> Therefore&#44; African-American patients with AUD may be more prone to sleep disturbances and experience more sleep problems compared to European-American patients&#46; In the present study&#44; it was found that African-American patients had higher sleep onset latency &#40;SOL&#41; and rapid eye movement &#40;REM&#41; percentage&#44; but lower slow wave sleep &#40;SWS&#41; percentage&#44; while European-American patients had decreased sleep efficiency &#40;SE&#41; and altered REM parameters &#40;REML and REMD&#41;&#46; Although direct comparison between African-American and European-American patients was not possible in this study&#44; it suggests that ethnic differences independently contribute to sleep disturbances in individuals with AUD&#46;</p><p id="para0028" class="elsevierStylePara elsevierViewall">Few studies have investigated the influence of sex differences on the impact of drinking to intoxication&#44; withdrawal&#44; and protracted abstinence on sleep&#46; Studies have shown that there are sex differences in drinking patterns and the way alcohol is processed in the body&#46; For instance&#44; women typically have less body water and more body fat compared to men&#46; As a result&#44; women often experience higher blood alcohol levels than men after consuming the same amount of alcohol due to its hydrophilic properties&#46;<a class="elsevierStyleCrossRef" href="#bib0056"><span class="elsevierStyleSup">56</span></a> Historically&#44; AUD has been more prevalent among men than women&#46; However&#44; the gender gap in both alcohol consumption and AUD is decreasing&#46;<a class="elsevierStyleCrossRef" href="#bib0057"><span class="elsevierStyleSup">57</span></a> Women with AUD typically have lower quality-of-life scores compared to men with the disorder&#46;<a class="elsevierStyleCrossRef" href="#bib0058"><span class="elsevierStyleSup">58</span></a> However&#44; no sexual differences were observed in the frequency of insomnia among men and women who received treatment for AUD&#46;<a class="elsevierStyleCrossRef" href="#bib0004"><span class="elsevierStyleSup">4</span></a> Colrain et al&#46; reported that women exhibited higher SE and more delta activity during NREM sleep compared to men&#44; irrespective of diagnosis&#46; They also found that men diagnosed with AUD showed a more substantial decrease in delta activity during NREM sleep compared to women with AUD&#46;<a class="elsevierStyleCrossRef" href="#bib0039"><span class="elsevierStyleSup">39</span></a> In this study&#44; we observed increased SOL&#44; N1&#37;&#44; REM&#37;&#44; REMD&#44; and 1st REM min&#44; but decreased TST&#44; SE&#44; N2&#37;&#44; and SWS&#37; in male patients with AUD&#44; which aligns with previous findings&#46; However&#44; studies that included both male and female patients demonstrated a decrease in N2 and SWS sleep&#46; We hypothesized that female patients may experience problems with NREM sleep&#46; Unfortunately&#44; due to the scarcity of research on female patients with AUD&#44; we could not thoroughly analyze sex differences&#46; Given the increasing prevalence of AUD in women&#44; it is crucial for future studies to include large samples of both men and women with AUD to better understand potential gender-related differences in the impact of heavy drinking&#44; alcohol withdrawal&#44; and prolonged abstinence on sleep&#46;</p><p id="para0029" class="elsevierStylePara elsevierViewall">Age is a critical factor related to AUD and sleep&#46;<a class="elsevierStyleCrossRef" href="#bib0059"><span class="elsevierStyleSup">59</span></a> Several studies have shown a clear decline in alcohol consumption as individuals age&#46; The period of highest consumption typically falls between the ages of 20 and 40&#44; while rates of alcohol abuse are more prevalent among young people and those in middle age&#46;<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">60</span></a> Some elderly individuals claim that smaller doses of alcohol have a stronger perceived effect&#44; as they may not socialize as much in settings where drinking is common or simply have a decreased desire to drink&#46; Others develop a distaste for the taste and effects of alcohol as they age&#46; Some mentioned giving up alcohol due to poor health or financial reasons&#46;<a class="elsevierStyleCrossRef" href="#bib0031"><span class="elsevierStyleSup">31</span></a> Compared to younger individuals&#44; older alcoholics are much more likely to have significant medical problems&#44; including sleep issues&#46; Typical symptoms of sleep problems in elderly patients with AUD include difficulty falling asleep and staying asleep&#44; early morning awakening&#44; and excessive daytime sleepiness&#46;<a class="elsevierStyleCrossRef" href="#bib0061"><span class="elsevierStyleSup">61</span></a> Thus&#44; the elderly population with AUD exhibited a decrease in prevalence but experienced more severe symptoms of sleep disturbances&#46; Our findings indicated that younger patients with AUD experienced issues with SOL&#44; SWS&#37;&#44; and REM&#37;&#44; whereas older patients primarily experienced problems with SE and NREM sleep&#46; Generally&#44; as individuals age&#44; the deeper stages of NREM sleep are often reduced or absent&#46; However&#44; REM sleep tends to be preserved&#44; which aligns with our study results&#46;</p><p id="para0030" class="elsevierStylePara elsevierViewall">The present study also investigated the effects of abstinence periods on sleep disturbance in individuals with AUD&#46; Abnormal sleep patterns in patients with AUD continue for several months or even years during the recovery and abstinence process&#46; Even after one to two years of quitting drinking&#44; sleep tends to remain short&#44; shallow&#44; and fragmented&#46;<a class="elsevierStyleCrossRef" href="#bib0062"><span class="elsevierStyleSup">62</span></a> Reportedly&#44; TST&#44; SOL&#44; SE&#44; SWS&#37;&#44; and REML improved slowly by the end of 1&#8211;2 weeks of abstinence&#44; but REM&#37; remained elevated in most patients with AUD even after more than 1 year of abstinence&#46;<a class="elsevierStyleCrossRef" href="#bib0048"><span class="elsevierStyleSup">48</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRef" href="#bib0063"><span class="elsevierStyleSup">63</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRef" href="#bib0064"><span class="elsevierStyleSup">64</span></a> The latest findings have shown that patients with AUD who had short periods of abstinence exhibited abnormal sleep parameters&#44; such as TST&#44; SOL&#44; SE&#44; and NREM&#37;&#44; as well as decreased SWS sleep and increased REM sleep&#46; The heightened REM sleep observed during withdrawal could be interpreted as a &#34;REM sleep rebound&#34;&#46;<a class="elsevierStyleCrossRef" href="#bib0006"><span class="elsevierStyleSup">6</span></a></p><p id="para0031" class="elsevierStylePara elsevierViewall">Several previous studies have indicated that the impact of alcohol on sleep is influenced by the amount consumed and works in both directions&#46;<a class="elsevierStyleCrossRef" href="#bib0006"><span class="elsevierStyleSup">6</span></a> Specifically&#44; lower doses of alcohol have been shown to potentially enhance TST&#46; On the other hand&#44; higher doses of alcohol have been linked to reduced REM sleep and heightened SWS&#46;<a class="elsevierStyleCrossRef" href="#bib0009"><span class="elsevierStyleSup">9</span></a> Despite this&#44; our study did not find any correlation between the amount of alcohol consumed and its impact on sleep for individuals with AUD&#46; A possible reason that may have contributed to the results is that all the patients included are AUD patients with high alcohol consumption&#46; This specific population could have unique physiological and psychological responses to alcohol that could impact the results&#46; Other reasons include a potential lack of an adequate sample size&#44; as well as individual differences that were not accounted for in the study&#44; such as individual tolerance levels and timing of consumption&#46;</p><p id="para0032" class="elsevierStylePara elsevierViewall">The sensitivity analysis results revealed that the study conducted by Irwin et al&#46; heightened the heterogeneity of the majority of the findings&#46;<a class="elsevierStyleCrossRef" href="#bib0017"><span class="elsevierStyleSup">17</span></a> The patients with AUD from the study were non-treatment-seeking&#44; a characteristic that distinguished them from the participants in other studies that were included&#46; Consequently&#44; these patients had a shorter period of abstinence&#44; suggesting that their clinical symptoms&#44; such as sleep problems&#44; were more severe&#46; This disparity in symptom severity can be considered as the primary factor contributing to the observed heterogeneity&#46; On the other hand&#44; the results of SOL&#44; SE&#44; N1&#44; N2&#44; SWS&#44; REMD&#44; and 1st REM min were relatively robust between AUD patients and healthy controls after the outlying study was omitted&#44; thus rendering them as reliable measures&#46; This suggests that they could effectively reflect the true characteristics of sleep disturbance in individuals with AUD&#46;</p><p id="para0033" class="elsevierStylePara elsevierViewall">Although this meta-analysis provides insights into sleep disturbance in AUD patients&#44; there are several limitations&#46; First&#44; the number of studies included was small&#46; This prevented us from examining the interaction effects of multiple moderator variables and exploring extended moderator analysis&#46; Similarly&#44; the small number of studies increased the second-order sampling error and decreased the accuracy in the estimation of the mean effect sizes&#46; Additionally&#44; AUD patients may experience different sleep disturbances during dependence&#44; abstinence&#44; and recovery&#46; The current results may reflect the sleep disturbance of AUD patients with abstinence&#44; thus limiting generalizability to other stages of AUD&#46; Finally&#44; the present study only reviewed the parameters of sleep macroarchitecture commonly reported in PSG studies with AUD patients&#59; however&#44; AUD-related sleep abnormalities are not limited to these variables&#46; Other variables&#44; such as periodic leg movements&#44; delta-band power&#47;integrated amplitude&#44; and quantitatively analyzed heart rate variability&#44; have also been observed&#46;<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">35</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">65</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRef" href="#bib0066"><span class="elsevierStyleSup">66</span></a> Therefore&#44; it is important for future studies to explore these variables and continue to investigate other aspects of sleep disturbances related to AUD&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cesectitle0021">Conclusion</span><p id="para0034" class="elsevierStylePara elsevierViewall">The main objective of this meta-analysis was to comprehensively examine the sleep macroarchitecture abnormalities in individuals with AUD and the impact of AUD-related factors and demographic factors on sleep disturbance&#46; The findings of this study indicated that individuals with AUD exhibited impairments in TST&#44; SOL&#44; SE&#44; NREM&#44; REM&#44; and 1st REM min compared to their healthy counterparts&#46; Furthermore&#44; factors such as ethnicity&#44; age&#44; gender&#44; abstinence period&#44; and concurrent substance use were found to moderate the effects of AUD on sleep macroarchitecture&#46; These results suggest that sleep macroarchitecture characteristics could serve as valuable descriptive parameters for addressing sleep-related issues associated with AUD and for profiling the clinical condition of patients&#46; Further exploration of the neurobiology of sleep in individuals with AUD is crucial to fully grasp the implications of these findings&#44; which should be considered within the context of normal developmental changes in sleep patterns&#46;</p></span><span id="sec0016" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cesectitle0022">Ethical considerations</span><p id="para0035" class="elsevierStylePara elsevierViewall">All analyses were based on previously published studies&#44; therefore no ethical approval or patient consent is required&#46;</p></span></span>"
    "textoCompletoSecciones" => array:1 [
      "secciones" => array:10 [
        0 => array:3 [
          "identificador" => "xres2115279"
          "titulo" => "Abstract"
          "secciones" => array:4 [
            0 => array:2 [
              "identificador" => "abss0001"
              "titulo" => "Background and objectives"
            ]
            1 => array:2 [
              "identificador" => "abss0002"
              "titulo" => "Methods"
            ]
            2 => array:2 [
              "identificador" => "abss0003"
              "titulo" => "Results"
            ]
            3 => array:2 [
              "identificador" => "abss0004"
              "titulo" => "Conclusions"
            ]
          ]
        ]
        1 => array:2 [
          "identificador" => "xpalclavsec1802047"
          "titulo" => "Keywords"
        ]
        2 => array:2 [
          "identificador" => "sec0001"
          "titulo" => "Introduction"
        ]
        3 => array:3 [
          "identificador" => "sec0002"
          "titulo" => "Methods"
          "secciones" => array:7 [
            0 => array:2 [
              "identificador" => "sec0003"
              "titulo" => "Design and registration"
            ]
            1 => array:2 [
              "identificador" => "sec0004"
              "titulo" => "Inclusion and exclusion criteria"
            ]
            2 => array:2 [
              "identificador" => "sec0005"
              "titulo" => "Search strategies"
            ]
            3 => array:2 [
              "identificador" => "sec0006"
              "titulo" => "Quality assessment"
            ]
            4 => array:2 [
              "identificador" => "sec0007"
              "titulo" => "Data extraction"
            ]
            5 => array:2 [
              "identificador" => "sec0008"
              "titulo" => "Data analysis"
            ]
            6 => array:2 [
              "identificador" => "sec0009"
              "titulo" => "Assessment of cumulative evidence"
            ]
          ]
        ]
        4 => array:3 [
          "identificador" => "sec0010"
          "titulo" => "Results"
          "secciones" => array:3 [
            0 => array:2 [
              "identificador" => "sec0011"
              "titulo" => "Characteristics of included studies"
            ]
            1 => array:2 [
              "identificador" => "sec0012"
              "titulo" => "Overall effect size and heterogeneity analysis"
            ]
            2 => array:2 [
              "identificador" => "sec0013"
              "titulo" => "Moderator analysis"
            ]
          ]
        ]
        5 => array:2 [
          "identificador" => "sec0014"
          "titulo" => "Discussion"
        ]
        6 => array:2 [
          "identificador" => "sec0015"
          "titulo" => "Conclusion"
        ]
        7 => array:2 [
          "identificador" => "sec0016"
          "titulo" => "Ethical considerations"
        ]
        8 => array:2 [
          "identificador" => "xack736522"
          "titulo" => "Funding"
        ]
        9 => array:1 [
          "titulo" => "References"
        ]
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "fechaRecibido" => "2023-06-20"
    "fechaAceptado" => "2023-09-03"
    "PalabrasClave" => array:1 [
      "en" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Keywords"
          "identificador" => "xpalclavsec1802047"
          "palabras" => array:5 [
            0 => "Alcohol use disorder"
            1 => "Sleep"
            2 => "Polysomnography"
            3 => "Sleep electroence-phalography"
            4 => "Meta-analysis"
          ]
        ]
      ]
    ]
    "tieneResumen" => true
    "resumen" => array:1 [
      "en" => array:3 [
        "titulo" => "Abstract"
        "resumen" => "<span id="abss0001" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cesectitle0002">Background and objectives</span><p id="spara008" class="elsevierStyleSimplePara elsevierViewall">Alcohol use disorder &#40;AUD&#41; is often linked to sleep problems&#44; but previous studies on sleep abnormalities in AUD have produced inconsistent results&#46; This study aims to provide a comprehensive analysis of objectively measured sleep abnormalities in AUD and determine the impact of related and demographic factors on sleep disturbance&#46;</p></span> <span id="abss0002" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cesectitle0003">Methods</span><p id="spara009" class="elsevierStyleSimplePara elsevierViewall">We conducted a comprehensive search of several databases from 1968 to 2023 to identify relevant studies&#46; A total of 12 studies&#44; consisting of 13 datasets&#44; were included in the analysis&#46; We extracted information on sleep microarchitecture&#44; as well as demographic and clinical features&#44; from each study&#46; The GRADE approach was used to assess the reliability and strength of the evidence&#46;</p></span> <span id="abss0003" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cesectitle0004">Results</span><p id="spara010" class="elsevierStyleSimplePara elsevierViewall">Patients with AUD exhibited several sleep abnormalities&#44; including longer sleep onset latency&#44; lower sleep efficiency&#44; increased stage 1 sleep&#44; decreased stage 2 sleep&#44; reduced slow wave sleep&#44; and elevated rapid eye movement &#40;REM&#41; sleep density and first REM minute&#46; The sleep patterns in individuals with AUD were also influenced by factors such as ethnicity&#44; age&#44; gender&#44; and abstinence period&#46;</p></span> <span id="abss0004" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cesectitle0005">Conclusions</span><p id="spara011" class="elsevierStyleSimplePara elsevierViewall">This study is the largest quantitative assessment of impaired sleep as a diagnostic marker in patients with AUD&#46; Understanding the sleep patterns of individuals with AUD can assist clinicians in developing effective treatment plans for managing sleep-related symptoms associated with AUD&#46;</p></span>"
        "secciones" => array:4 [
          0 => array:2 [
            "identificador" => "abss0001"
            "titulo" => "Background and objectives"
          ]
          1 => array:2 [
            "identificador" => "abss0002"
            "titulo" => "Methods"
          ]
          2 => array:2 [
            "identificador" => "abss0003"
            "titulo" => "Results"
          ]
          3 => array:2 [
            "identificador" => "abss0004"
            "titulo" => "Conclusions"
          ]
        ]
      ]
    ]
    "apendice" => array:1 [
      0 => array:1 [
        "seccion" => array:1 [
          0 => array:4 [
            "apendice" => "<p id="para0036a" class="elsevierStylePara elsevierViewall"><elsevierMultimedia ident="ecom0001"></elsevierMultimedia><elsevierMultimedia ident="ecom0002"></elsevierMultimedia></p>"
            "etiqueta" => "Appendix"
            "titulo" => "Supplementary materials"
            "identificador" => "sec0018"
          ]
        ]
      ]
    ]
    "multimedia" => array:8 [
      0 => array:8 [
        "identificador" => "fig0001"
        "etiqueta" => "Fig&#46; 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 2228
            "Ancho" => 2500
            "Tamanyo" => 233095
          ]
        ]
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "alt0003"
            "detalle" => "Fig "
            "rol" => "short"
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spara001" class="elsevierStyleSimplePara elsevierViewall">The flow diagram of included studies&#46;</p>"
        ]
      ]
      1 => array:8 [
        "identificador" => "fig0002"
        "etiqueta" => "Fig&#46; 2"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr2.jpeg"
            "Alto" => 1474
            "Ancho" => 3500
            "Tamanyo" => 563169
          ]
        ]
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "alt0004"
            "detalle" => "Fig "
            "rol" => "short"
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spara002" class="elsevierStyleSimplePara elsevierViewall">Forest plots describing the features of sleep macroarchitecture&#46; Features of sleep macroarchitecture include &#40;A&#41; total sleep time&#44; &#40;B&#41; sleep onset latency&#44; &#40;C&#41; sleep efficiency&#44; &#40;D&#41; wake after sleep onset&#44; &#40;E&#41; stage 1&#44; &#40;F&#41; stage 2&#44; &#40;G&#41; slow wave sleep&#44; &#40;H&#41; rapid eye movement sleep&#44; &#40;I&#41; rapid eye movement sleep latency&#44; &#40;J&#41; rapid eye movement sleep latency&#44; &#40;K&#41; 1st rapid eye movement sleep minutes&#46;</p>"
        ]
      ]
      2 => array:8 [
        "identificador" => "fig0003"
        "etiqueta" => "Fig&#46; 3"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr3.jpeg"
            "Alto" => 1827
            "Ancho" => 3500
            "Tamanyo" => 662196
          ]
        ]
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "alt0005"
            "detalle" => "Fig "
            "rol" => "short"
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spara003" class="elsevierStyleSimplePara elsevierViewall">Results of &#8220;one-study removed&#8221; sensitivity analysis for all studies included on the features of sleep macroarchitecture&#46; Features of sleep macroarchitecture include &#40;A&#41; total sleep time&#44; &#40;B&#41; sleep onset latency&#44; &#40;C&#41; sleep efficiency&#44; &#40;D&#41; wake after sleep onset&#44; &#40;E&#41; stage 1&#44; &#40;F&#41; stage 2&#44; &#40;G&#41; slow wave sleep&#44; &#40;H&#41; rapid eye movement sleep&#44; &#40;I&#41; rapid eye movement sleep latency&#44; &#40;J&#41; rapid eye movement sleep latency&#44; &#40;K&#41; 1st rapid eye movement sleep minutes&#46;</p>"
        ]
      ]
      3 => array:8 [
        "identificador" => "fig0004"
        "etiqueta" => "Fig&#46; 4"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr4.jpeg"
            "Alto" => 1481
            "Ancho" => 3500
            "Tamanyo" => 130110
          ]
        ]
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "alt0006"
            "detalle" => "Fig "
            "rol" => "short"
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spara004" class="elsevierStyleSimplePara elsevierViewall">Funnel plots describing the spread of studies on the features of sleep macroarchitecture&#46; Features of sleep macroarchitecture include &#40;A&#41; total sleep time&#44; &#40;B&#41; sleep onset latency&#44; &#40;C&#41; sleep efficiency&#44; &#40;D&#41; wake after sleep onset&#44; &#40;E&#41; stage 1&#44; &#40;F&#41; stage 2&#44; &#40;G&#41; slow wave sleep&#44; &#40;H&#41; rapid eye movement sleep&#44; &#40;I&#41; rapid eye movement sleep latency&#44; &#40;J&#41; rapid eye movement sleep latency&#44; &#40;K&#41; 1st rapid eye movement sleep minutes&#46; Asymmetry in funnel plots represents publication bias&#46;</p>"
        ]
      ]
      4 => array:8 [
        "identificador" => "tbl0001"
        "etiqueta" => "Table 1"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "alt0001"
            "detalle" => "Table "
            "rol" => "short"
          ]
        ]
        "tabla" => array:2 [
          "leyenda" => "<p id="spara006" class="elsevierStyleSimplePara elsevierViewall">Abbreviations&#58; &#37;&#44; percentage&#59; CAGE&#44; the cut down&#44; annoyed by criticism&#44; guilty about drinking and eye-opener drinks questionnaire&#59; DSM-III&#47;DSM-IV&#44; third&#47;fourth edition of the diagnostic and statistical manual of mental disorders&#59; ICD-10&#44; the 10th revision of the International Statistical Classification of Diseases and Related Health Problems&#59; No&#46;&#44; number&#59; NR&#44; not reported&#59; SD&#44; standard deviation&#59; yrs&#44; years&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><a name="en0001"></a><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">First Author&#47;year&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><a name="en0002"></a><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">Sample size &#40;Case&#47;Control&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><a name="en0003"></a><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">Ethnicity&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><a name="en0004"></a><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">Mean age &#40;SD&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><a name="en0005"></a><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">Education&#44; yrs &#40;SD&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><a name="en0006"></a><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">Diagnostic tools&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><a name="en0007"></a><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">Length of dependence&#44; yrs &#40;SD&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><a name="en0008"></a><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">Duration of abstinence &#40;SD&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><a name="en0009"></a><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">Drinks&#47;day &#40;SD&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><a name="en0010"></a><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">Drinking days&#47;month &#40;SD&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><a name="en0011"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">Irwin MR&#47;2000<span class="elsevierStyleSup">a</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0012"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">14&#47;14&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0013"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">African&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0014"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">38&#46;6 &#40;6&#46;8&#41;38&#46;4 &#40;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0015"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">12&#46;8 &#40;1&#46;1&#41;14&#46;2 &#40;1&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0016"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">DSM-IV&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0017"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">NR&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0018"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">30&#46;3 &#40;20&#46;9&#41; days&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0019"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">13 &#40;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0020"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">24&#46;8 &#40;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><a name="en0021"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">Irwin MR&#47;2000<span class="elsevierStyleSup">b</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0022"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">17&#47;17&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0023"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">European&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0024"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">48&#46;1 &#40;11&#46;2&#41;45&#46;7 &#40;13&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0025"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">13&#46;5 &#40;1&#46;8&#41;16&#46;1 &#40;1&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0026"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">DSM-IV&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0027"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">NR&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0028"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">29&#46;4 &#40;9&#46;6&#41; days&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0029"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">12&#46;4 &#40;6&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0030"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">25&#46;5 &#40;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><a name="en0031"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">Gann H&#47;2002&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0032"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">40&#47;30&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0033"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">European&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0034"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">43 &#40;9&#41;43 &#40;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0035"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">NR&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0036"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">DSM-III-R&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0037"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">13 &#40;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0038"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">16 &#40;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0039"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">NR&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0040"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">NR&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><a name="en0041"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">Kuhlwein E&#47;2003&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0042"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">11&#47;10&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0043"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">African&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0044"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">39&#46;4 &#40;5&#46;5&#41;38&#46;2 &#40;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0045"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">NR&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0046"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">DSM-IV&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0047"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">NR&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0048"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">25&#46;6 &#40;6&#46;4&#41; days&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0049"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">15&#46;8 &#40;16&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0050"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">27&#46;1 &#40;6&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><a name="en0051"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">Redwine L&#47;2003&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0052"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">24&#47;23&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0053"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">African&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0054"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">42&#46;6 &#40;6&#46;8&#41;41&#46;3 &#40;8&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0055"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">13&#46;2 &#40;1&#46;3&#41;14&#46;3 &#40;1&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0056"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">DSM-IV&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0057"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">NR&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0058"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">23&#46;1 &#40;11&#46;7&#41; days&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0059"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">14&#46;4 &#40;11&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0060"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">26&#46;3 &#40;5&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><a name="en0061"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">Gann H&#47;2004&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0062"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">40&#47;40&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0063"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">European&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0064"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">43 &#40;9&#41;42&#46;7 &#40;10&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0065"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">NR&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0066"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">DSM-III-R&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0067"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">13 &#40;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0068"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">20 &#40;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0069"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">NR&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0070"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">NR&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><a name="en0071"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">Irwin MR&#47;2006&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0072"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">14&#47;14&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0073"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">Mixed&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0074"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">39&#46;1 &#40;6&#46;4&#41;37&#46;5 &#40;9&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0075"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">NR&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0076"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">DSM-IV&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0077"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">15&#46;1 &#40;7&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0078"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">31 &#40;28&#41; days&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0079"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">10&#46;7 &#40;8&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0080"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">24&#46;9 &#40;5&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><a name="en0081"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">Colrain IM&#47;2009&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0082"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">42&#47;42&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0083"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">Mixed&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0084"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">49&#46;1 &#40;8&#46;5&#41;51&#46;1 &#40;9&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0085"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">NR&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0086"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">DSM-IV&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0087"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">NR&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0088"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">&#8804; 30 days&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0089"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">NR&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0090"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">NR&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><a name="en0091"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">Cohen-Zion M&#47;2009&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0092"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">29&#47;20&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0093"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">Mixed&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0094"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">18&#46;2 &#40;1&#46;1&#41;18&#46;4 &#40;1&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0095"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">NR&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0096"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">DSM-IV&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0097"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">NR&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0098"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">11&#46;4 &#40;39&#46;3&#41; days&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0099"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">NR&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0100"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">NR&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><a name="en0101"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">Sahlin C&#47;2009&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0102"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">21&#47;360&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0103"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">European&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0104"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">NR&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0105"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">NR&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0106"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">CAGE&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0107"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">NR&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0108"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">NR&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0109"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">NR&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0110"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">NR&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><a name="en0111"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">Zambotti M&#47;2014&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0112"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">14&#47;16&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0113"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">Mixed&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0114"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">42 &#40;9&#41;45&#46;2 &#40;9&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0115"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">12&#46;6 &#40;2&#46;2&#41;17&#46;1 &#40;1&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0116"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">DSM-IV&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0117"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">17&#46;2 &#40;9&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0118"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">19&#46;8 &#40;10&#46;1&#41; days&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0119"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">NR&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0120"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">NR&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><a name="en0121"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">Irwin MR&#47;2016&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0122"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">73&#47;108&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0123"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">Mixed&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0124"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">41&#46;9 &#40;9&#46;5&#41;40&#46;3 &#40;11&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0125"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">13&#46;1 &#40;3&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0126"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">DSM-IV&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0127"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">NR&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0128"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">&#8804; 2 weeks&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0129"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">12&#46;7 &#40;8&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0130"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">24&#46;1 &#40;7&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><a name="en0131"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">Singh LK&#47;2018&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0132"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">20&#47;20&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0133"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">Mixed&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0134"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">36&#46;7 &#40;5&#46;81&#41;36&#46;8 &#40;5&#46;83&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0135"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">NR&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0136"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">ICD-10&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0137"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">14&#46;9 &#40;7&#46;53&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0138"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">3&#8211;4 weeks&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0139"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">NR&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0140"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">NR&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab3497806.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spara005" class="elsevierStyleSimplePara elsevierViewall">Demographic and clinical information of studies included&#46;</p>"
        ]
      ]
      5 => array:8 [
        "identificador" => "tbl0002"
        "etiqueta" => "Table 2"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "alt0002"
            "detalle" => "Table "
            "rol" => "short"
          ]
        ]
        "tabla" => array:2 [
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><a name="en0141"></a><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">Sleep parameters&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><a name="en0142"></a><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">No&#46; of datasets&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><a name="en0143"></a><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">No&#46; of participants &#40;Case&#47;Control&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><a name="en0144"></a><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">Mean of case&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><a name="en0145"></a><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">Mean of control&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><a name="en0146"></a><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">Hedges&#8217; g&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><a name="en0147"></a><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">95&#37;CI&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><a name="en0148"></a><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">Q&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><a name="en0149"></a><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">I<span class="elsevierStyleSup">2</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><a name="en0150"></a><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">Begg&#39;s test&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><a name="en0151"></a><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">Egger&#39;s test&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><a name="en0152"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">TST min&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0153"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="top">12&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0154"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">319&#47;684&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0155"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">371&#46;06&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0156"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">387&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0157"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="top">&#8722;0&#46;39<a class="elsevierStyleCrossRef" href="#tb2fn1">&#42;</a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0158"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="top">&#8722;0&#46;75&#47;&#8722;0&#46;04&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0159"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">77&#46;79<a class="elsevierStyleCrossRef" href="#tb2fn3"><span class="elsevierStyleSup">&#8270;&#8270;&#8270;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0160"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">85&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0161"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">0&#46;64&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0162"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">0&#46;38&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><a name="en0163"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">SOL min&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0164"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="top">13&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0165"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">359&#47;714&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0166"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">26&#46;04&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0167"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">14&#46;34&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0168"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="top">0&#46;58<a class="elsevierStyleCrossRef" href="#tb2fn2"><span class="elsevierStyleSup">&#8270;&#8270;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0169"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="top">0&#46;23&#47;0&#46;94&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0170"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">83&#46;62<a class="elsevierStyleCrossRef" href="#tb2fn3"><span class="elsevierStyleSup">&#8270;&#8270;&#8270;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0171"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">85&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0172"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">0&#46;68&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0173"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">0&#46;69&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><a name="en0174"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">SE&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0175"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="top">13&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0176"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">359&#47;714&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0177"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">80&#46;53&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0178"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">84&#46;33&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0179"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="top">&#8722;0&#46;45<a class="elsevierStyleCrossRef" href="#tb2fn2"><span class="elsevierStyleSup">&#8270;&#8270;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0180"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="top">&#8722;0&#46;73&#47;&#8722;0&#46;16&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0181"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">50&#46;55<a class="elsevierStyleCrossRef" href="#tb2fn3"><span class="elsevierStyleSup">&#8270;&#8270;&#8270;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0182"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">76&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0183"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">0&#46;77&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0184"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">0&#46;85&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><a name="en0185"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">WASO&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0186"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="top">6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0187"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">238&#47;256&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0188"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">27&#46;21&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0189"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">26&#46;74&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0190"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="top">0&#46;27&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0191"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="top">&#8722;0&#46;09&#47;0&#46;63&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0192"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">19&#46;92<a class="elsevierStyleCrossRef" href="#tb2fn2"><span class="elsevierStyleSup">&#8270;&#8270;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0193"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">74&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0194"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">0&#46;72&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0195"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">0&#46;13&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><a name="en0196"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">S1&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0197"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="top">12&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0198"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">348&#47;704&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0199"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">12&#46;66&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0200"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">9&#46;71&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0201"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="top">0&#46;83<a class="elsevierStyleCrossRef" href="#tb2fn2"><span class="elsevierStyleSup">&#8270;&#8270;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0202"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="top">0&#46;21&#47;1&#46;45&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0203"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">188&#46;92<a class="elsevierStyleCrossRef" href="#tb2fn3"><span class="elsevierStyleSup">&#8270;&#8270;&#8270;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0204"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">94&#46;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0205"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">0&#46;06&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0206"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">0&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><a name="en0207"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">S2&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0208"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="top">12&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0209"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">348&#47;704&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0210"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">56&#46;85&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0211"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">59&#46;08&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0212"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="top">&#8722;0&#46;41<a class="elsevierStyleCrossRef" href="#tb2fn1">&#42;</a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0213"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="top">&#8722;0&#46;73&#47;&#8722;0&#46;08&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0214"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">71&#46;75<a class="elsevierStyleCrossRef" href="#tb2fn3"><span class="elsevierStyleSup">&#8270;&#8270;&#8270;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0215"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">84&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0216"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">0&#46;38&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0217"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">0&#46;34&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><a name="en0218"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">SWS&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0219"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="top">12&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0220"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">348&#47;704&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0221"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">5&#46;78&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0222"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">9&#46;59&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0223"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="top">&#8722;1&#46;06<a class="elsevierStyleCrossRef" href="#tb2fn2"><span class="elsevierStyleSup">&#8270;&#8270;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0224"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="top">&#8722;1&#46;89&#47;&#8722;0&#46;23&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0225"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">228&#46;28<a class="elsevierStyleCrossRef" href="#tb2fn3"><span class="elsevierStyleSup">&#8270;&#8270;&#8270;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0226"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">95&#46;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0227"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">0&#46;04&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0228"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">0&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><a name="en0229"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">REM&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0230"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="top">12&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0231"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">348&#47;704&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0232"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">21&#46;32&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0233"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">18&#46;95&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0234"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="top">0&#46;75&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0235"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="top">&#8722;0&#46;06&#47;1&#46;57&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0236"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">245&#46;56<a class="elsevierStyleCrossRef" href="#tb2fn3"><span class="elsevierStyleSup">&#8270;&#8270;&#8270;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0237"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">95&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0238"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">0&#46;38&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0239"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">0&#46;64&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><a name="en0240"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">REML&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0241"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="top">11&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0242"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">318&#47;334&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0243"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">61&#46;13&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0244"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">66&#46;42&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0245"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="top">&#8722;0&#46;35&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0246"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="top">&#8722;0&#46;89&#47;0&#46;20&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0247"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">127&#46;93<a class="elsevierStyleCrossRef" href="#tb2fn3"><span class="elsevierStyleSup">&#8270;&#8270;&#8270;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0248"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">92&#46;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0249"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">0&#46;65&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0250"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">0&#46;39&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><a name="en0251"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">REMD&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0252"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="top">8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0253"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">251&#47;266&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0254"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">10&#46;77&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0255"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">7&#46;63&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0256"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="top">1&#46;14<a class="elsevierStyleCrossRef" href="#tb2fn1">&#42;</a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0257"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="top">0&#46;03&#47;2&#46;26&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0258"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">191&#46;67<a class="elsevierStyleCrossRef" href="#tb2fn3"><span class="elsevierStyleSup">&#8270;&#8270;&#8270;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0259"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">96&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0260"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">0&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0261"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">0&#46;66&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><a name="en0262"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">1st REM min&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0263"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="top">7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0264"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">222&#47;246&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0265"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">21&#46;03&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0266"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">17&#46;03&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0267"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="top">0&#46;59<a class="elsevierStyleCrossRef" href="#tb2fn1">&#42;</a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0268"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="top">0&#46;09&#47;1&#46;09&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0269"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">56&#46;64<a class="elsevierStyleCrossRef" href="#tb2fn3"><span class="elsevierStyleSup">&#8270;&#8270;&#8270;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0270"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">89&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0271"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">0&#46;56&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><a name="en0272"></a><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="top">0&#46;39&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab3497805.png"
              ]
            ]
          ]
          "notaPie" => array:3 [
            0 => array:3 [
              "identificador" => "tb2fn1"
              "etiqueta" => "&#8270;"
              "nota" => "<p class="elsevierStyleNotepara" id="notep0002">p&#60; 0&#46;05&#46;</p>"
            ]
            1 => array:3 [
              "identificador" => "tb2fn2"
              "etiqueta" => "&#8270;&#8270;"
              "nota" => "<p class="elsevierStyleNotepara" id="notep0003">p&#60; 0&#46;01&#46;</p>"
            ]
            2 => array:3 [
              "identificador" => "tb2fn3"
              "etiqueta" => "&#8270;&#8270;&#8270;"
              "nota" => "<p class="elsevierStyleNotepara" id="notep0004">p&#60; 0&#46;001&#46;</p> <p class="elsevierStyleNotepara" id="notep0005">Abbreviations&#58; &#37;&#44; percentage&#59; CI&#44; confidence interval&#59; min&#44; minutes&#59; Q&#44; Cochran&#39;s Q statistic&#59; REM&#44; rapid eye movement sleep&#59; REMD&#44; rapid eye movement sleep density&#59; REML&#44; rapid eye movement sleep latency&#59; S1&#44; stage 1&#59; S2&#44; stage2&#59; SE&#44; sleep efficiency&#59; SOL&#44; sleep onset latency&#59; SWS&#44; slow wave sleep&#59; TST&#44; total sleep time&#59; WASO&#44; wake after sleep onset&#46;</p>"
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spara007" class="elsevierStyleSimplePara elsevierViewall">Summary of meta-analyses&#46;</p>"
        ]
      ]
      6 => array:6 [
        "identificador" => "ecom0001"
        "tipo" => "MULTIMEDIAECOMPONENTE"
        "mostrarFloat" => false
        "mostrarDisplay" => true
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "alt0007"
            "detalle" => "Image&#44; application "
            "rol" => "short"
          ]
        ]
        "Ecomponente" => array:2 [
          "fichero" => "mmc1.docx"
          "ficheroTamanyo" => 14981
        ]
      ]
      7 => array:6 [
        "identificador" => "ecom0002"
        "tipo" => "MULTIMEDIAECOMPONENTE"
        "mostrarFloat" => false
        "mostrarDisplay" => true
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "alt0008"
            "detalle" => "Image&#44; application "
            "rol" => "short"
          ]
        ]
        "Ecomponente" => array:2 [
          "fichero" => "mmc2.docx"
          "ficheroTamanyo" => 43914
        ]
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "cebibsec1"
          "bibliografiaReferencia" => array:66 [
            0 => array:3 [
              "identificador" => "bib0001"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Alcohol Facts and Statistics"
                      "autores" => array:1 [
                        0 => array:2 [
                          "colaboracion" => "NIAAA"
                          "etal" => false
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Libro" => array:2 [
                        "fecha" => "2019"
                        "editorial" => "National Institute on Alcohol Abuse and Alcoholism"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0002"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Alcohol use disorders"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "A&#46;F&#46; Carvalho"
                            1 => "M&#46; Heilig"
                            2 => "A&#46; Perez"
                            3 => "C&#46; Probst"
                            4 => "J&#46; Rehm"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/S0140-6736(19)31775-1"
                      "Revista" => array:7 [
                        "tituloSerie" => "Lancet"
                        "fecha" => "2019"
                        "volumen" => "394"
                        "numero" => "10200"
                        "paginaInicial" => "781"
                        "paginaFinal" => "792"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/31478502"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0003"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Proposed supplements and amendments to &#39;A Manual of Standardized Terminology&#44; Techniques and Scoring System for Sleep Stages of Human Subjects&#39;&#44; the Rechtschaffen &#38; Kales &#40;1968&#41; standard"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "T&#46; Hori"
                            1 => "Y&#46; Sugita"
                            2 => "E&#46; Koga"
                            3 => "S&#46; Shirakawa"
                            4 => "K&#46; Inoue"
                            5 => "S&#46; Uchida"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1046/j.1440-1819.2001.00810.x"
                      "Revista" => array:7 [
                        "tituloSerie" => "Psychiatry Clin Neurosci"
                        "fecha" => "2001"
                        "volumen" => "55"
                        "numero" => "3"
                        "paginaInicial" => "305"
                        "paginaFinal" => "310"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11422885"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0004"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Insomnia&#44; self-medication&#44; and relapse to alcoholism"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "K&#46;J&#46; Brower"
                            1 => "M&#46;S&#46; Aldrich"
                            2 => "E&#46;A&#46; Robinson"
                            3 => "R&#46;A&#46; Zucker"
                            4 => "J&#46;F&#46; Greden"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1176/appi.ajp.158.3.399"
                      "Revista" => array:7 [
                        "tituloSerie" => "Am J Psychiatry"
                        "fecha" => "2001"
                        "volumen" => "158"
                        "numero" => "3"
                        "paginaInicial" => "399"
                        "paginaFinal" => "404"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11229980"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0005"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Increased daytime sleepiness enhances ethanol&#39;s sedative effects"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "A&#46; Zwyghuizen-Doorenbos"
                            1 => "T&#46; Roehrs"
                            2 => "J&#46; Lamphere"
                            3 => "F&#46; Zorick"
                            4 => "T&#46; Roth"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:7 [
                        "tituloSerie" => "Neuropsychopharmacology"
                        "fecha" => "1988"
                        "volumen" => "1"
                        "numero" => "4"
                        "paginaInicial" => "279"
                        "paginaFinal" => "286"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/3251507"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0006"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Disturbed sleep and its relationship to alcohol use"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "M&#46;D&#46; Stein"
                            1 => "P&#46;D&#46; Friedmann"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:4 [
                        "tituloSerie" => "Subst Abus"
                        "fecha" => "2005"
                        "volumen" => "26"
                        "numero" => "1"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib0007"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Epidemiology of alcohol and medication as aids to sleep in early adulthood"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "E&#46;O&#46; Johnson"
                            1 => "T&#46; Roehrs"
                            2 => "T&#46; Roth"
                            3 => "N Breslau"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1093/sleep/21.2.178"
                      "Revista" => array:7 [
                        "tituloSerie" => "Sleep"
                        "fecha" => "1998"
                        "volumen" => "21"
                        "numero" => "2"
                        "paginaInicial" => "178"
                        "paginaFinal" => "186"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9542801"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib0008"
              "etiqueta" => "8"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Alcohol Dependence and Its Relationship With Insomnia and Other Sleep Disorders"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "S&#46; Chakravorty"
                            1 => "N&#46;S&#46; Chaudhary"
                            2 => "K&#46;J&#46; Brower"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/acer.13217"
                      "Revista" => array:7 [
                        "tituloSerie" => "Alcohol Clin Exp Res"
                        "fecha" => "2016"
                        "volumen" => "40"
                        "numero" => "11"
                        "paginaInicial" => "2271"
                        "paginaFinal" => "2282"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27706838"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib0009"
              "etiqueta" => "9"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Ethanol as a hypnotic in insomniacs&#58; self administration and effects on sleep and mood"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "T&#46; Roehrs"
                            1 => "K&#46; Papineau"
                            2 => "L&#46; Rosenthal"
                            3 => "T&#46; Roth"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/S0893-133X(98)00068-2"
                      "Revista" => array:7 [
                        "tituloSerie" => "Neuropsychopharmacology"
                        "fecha" => "1999"
                        "volumen" => "20"
                        "numero" => "3"
                        "paginaInicial" => "279"
                        "paginaFinal" => "286"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10063488"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib0010"
              "etiqueta" => "10"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Alcohol and sleep in young adults"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "O&#46;H&#46; Rundell"
                            1 => "B&#46;K&#46; Lester"
                            2 => "W&#46;J&#46; Griffiths"
                            3 => "H&#46;L&#46; Williams"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Psychopharmacologia"
                        "fecha" => "1972"
                        "volumen" => "26"
                        "numero" => "3"
                        "paginaInicial" => "201"
                        "paginaFinal" => "218"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib0011"
              "etiqueta" => "11"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The acute effects of alcohol on sleep architecture in late adolescence"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "J&#46;K&#46;M&#46; Chan"
                            1 => "J&#46; Trinder"
                            2 => "Andrewes HE"
                            3 => "I&#46;M&#46; Colrain"
                            4 => "C&#46;L&#46; Nicholas"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/acer.12141"
                      "Revista" => array:7 [
                        "tituloSerie" => "Alcohol Clin Exp Res"
                        "fecha" => "2013"
                        "volumen" => "37"
                        "numero" => "10"
                        "paginaInicial" => "1720"
                        "paginaFinal" => "1728"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23800287"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            11 => array:3 [
              "identificador" => "bib0012"
              "etiqueta" => "12"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Persistent insomnia&#44; abstinence&#44; and moderate drinking in alcohol-dependent individuals"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "K&#46;J&#46; Brower"
                            1 => "A&#46; Krentzman"
                            2 => "E&#46;A&#46;R&#46; Robinson"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/j.1521-0391.2011.00152.x"
                      "Revista" => array:7 [
                        "tituloSerie" => "Am J Addict"
                        "fecha" => "2011"
                        "volumen" => "20"
                        "numero" => "5"
                        "paginaInicial" => "435"
                        "paginaFinal" => "440"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21838842"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib0013"
              "etiqueta" => "13"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Assessment and treatment of insomnia in adult patients with alcohol use disorders"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "K&#46;J&#46; Brower"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.alcohol.2014.12.003"
                      "Revista" => array:7 [
                        "tituloSerie" => "Alcohol"
                        "fecha" => "2015"
                        "volumen" => "49"
                        "numero" => "4"
                        "paginaInicial" => "417"
                        "paginaFinal" => "427"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25957855"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            13 => array:3 [
              "identificador" => "bib0014"
              "etiqueta" => "14"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The sleep of abstinent pure primary alcoholic patients&#58; natural course and relationship to relapse"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "S&#46;P&#46; Drummond"
                            1 => "J&#46;C&#46; Gillin"
                            2 => "T&#46;L&#46; Smith"
                            3 => "A&#46; DeModena"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:7 [
                        "tituloSerie" => "Alcohol Clin Exp Res"
                        "fecha" => "1998"
                        "volumen" => "22"
                        "numero" => "8"
                        "paginaInicial" => "1796"
                        "paginaFinal" => "1802"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9835298"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            14 => array:3 [
              "identificador" => "bib0015"
              "etiqueta" => "15"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Polysomnography"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "B&#46; Jafari"
                            1 => "V&#46; Mohsenin"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.ccm.2010.02.005"
                      "Revista" => array:7 [
                        "tituloSerie" => "Clin Chest Med"
                        "fecha" => "2010"
                        "volumen" => "31"
                        "numero" => "2"
                        "paginaInicial" => "287"
                        "paginaFinal" => "297"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20488287"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            15 => array:3 [
              "identificador" => "bib0016"
              "etiqueta" => "16"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Polysomnographic comparison between patients with primary alcohol dependency during subacute withdrawal and patients with a major depression"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "H&#46; Gann"
                            1 => "D&#46; van Calker"
                            2 => "B&#46; Feige"
                            3 => "O&#46; Cloot"
                            4 => "R&#46; Br&#252;ck"
                            5 => "M&#46; Berger"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s00406-004-0494-1"
                      "Revista" => array:7 [
                        "tituloSerie" => "Eur Arch Psychiatry Clin Neurosci"
                        "fecha" => "2004"
                        "volumen" => "254"
                        "numero" => "4"
                        "paginaInicial" => "263"
                        "paginaFinal" => "271"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15309398"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            16 => array:3 [
              "identificador" => "bib0017"
              "etiqueta" => "17"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Polysomnographic measures of sleep in cocaine dependence and alcohol dependence&#58; implications for age-related loss of slow wave&#44; stage 3 sleep"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "M&#46;R&#46; Irwin"
                            1 => "M&#46;F&#46; Bjurstrom"
                            2 => "R&#46; Olmstead"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/add.13300"
                      "Revista" => array:7 [
                        "tituloSerie" => "Addiction"
                        "fecha" => "2016"
                        "volumen" => "111"
                        "numero" => "6"
                        "paginaInicial" => "1084"
                        "paginaFinal" => "1092"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26749502"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            17 => array:3 [
              "identificador" => "bib0018"
              "etiqueta" => "18"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Sleep architecture and EEG power spectra in recently detoxified alcohol dependent patients"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "L&#46;K&#46; Singh"
                            1 => "S&#46;H&#46; Nizamie"
                            2 => "S&#46;K&#46; Tikka"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Asian J Psychiatr"
                        "fecha" => "2018"
                        "volumen" => "32"
                        "paginaInicial" => "126"
                        "paginaFinal" => "136"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            18 => array:3 [
              "identificador" => "bib0019"
              "etiqueta" => "19"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Neuropsychological and Neuroimaging Examinations of Self-Reported Sleep Quality in Alcohol Use Disorder With and Without Korsakoff&#39;s Syndrome"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "A&#46; Laniepce"
                            1 => "S&#46; Segobin"
                            2 => "C&#46; Lannuzel"
                            3 => "C&#46; Boudehent"
                            4 => "L&#46; Ritz"
                            5 => "L&#46; Urso"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/acer.13997"
                      "Revista" => array:7 [
                        "tituloSerie" => "Alcohol Clin Exp Res"
                        "fecha" => "2019"
                        "volumen" => "43"
                        "numero" => "5"
                        "paginaInicial" => "952"
                        "paginaFinal" => "964"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30861140"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            19 => array:3 [
              "identificador" => "bib0020"
              "etiqueta" => "20"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Impaired sleep in alcohol misusers and dependent alcoholics and the impact upon outcome"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "J&#46;H&#46; Foster"
                            1 => "T&#46;J&#46; Peters"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Alcohol Clin Exp Res"
                        "fecha" => "1999"
                        "volumen" => "23"
                        "numero" => "6"
                        "paginaInicial" => "1044"
                        "paginaFinal" => "1051"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            20 => array:3 [
              "identificador" => "bib0021"
              "etiqueta" => "21"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The PRISMA 2020 statement&#58; an updated guideline for reporting systematic reviews"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46;J&#46; Page"
                            1 => "J&#46;E&#46; McKenzie"
                            2 => "P&#46;M&#46; Bossuyt"
                            3 => "I&#46; Boutron"
                            4 => "T&#46;C&#46; Hoffmann"
                            5 => "C&#46;D&#46; Mulrow"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1136/bmj.n71"
                      "Revista" => array:5 [
                        "tituloSerie" => "BMJ"
                        "fecha" => "2021"
                        "volumen" => "372"
                        "paginaInicial" => "n71"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/33782057"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            21 => array:3 [
              "identificador" => "bib0022"
              "etiqueta" => "22"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Critical evaluation of the Newcastle-Ottawa scale for the assessment of the quality of nonrandomized studies in meta-analyses"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "A&#46; Stang"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s10654-010-9491-z"
                      "Revista" => array:7 [
                        "tituloSerie" => "Eur J Epidemiol"
                        "fecha" => "2010"
                        "volumen" => "25"
                        "numero" => "9"
                        "paginaInicial" => "603"
                        "paginaFinal" => "605"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20652370"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            22 => array:3 [
              "identificador" => "bib0023"
              "etiqueta" => "23"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Practical Guide to Meta-analysis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "S&#46; Arya"
                            1 => "T&#46;A&#46; Schwartz"
                            2 => "A&#46;A&#46; Ghaferi"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1001/jamasurg.2019.4523"
                      "Revista" => array:7 [
                        "tituloSerie" => "JAMA Surg"
                        "fecha" => "2020"
                        "volumen" => "155"
                        "numero" => "5"
                        "paginaInicial" => "430"
                        "paginaFinal" => "431"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/31995161"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            23 => array:3 [
              "identificador" => "bib0024"
              "etiqueta" => "24"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Measuring inconsistency in meta-analyses"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "J&#46;P&#46;T&#46; Higgins"
                            1 => "S&#46;G&#46; Thompson"
                            2 => "J&#46;J&#46; Deeks"
                            3 => "D&#46;G&#46; Altman"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "BMJ"
                        "fecha" => "2003"
                        "volumen" => "327"
                        "numero" => "7414"
                        "paginaInicial" => "557"
                        "paginaFinal" => "560"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            24 => array:3 [
              "identificador" => "bib0025"
              "etiqueta" => "25"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Publication Bias&#46; Introduction to Meta-Analysis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "M&#46;B&#46; LVH"
                            1 => "J&#46;P&#46;T&#46; Higgins"
                            2 => "H&#46;R&#46; Rothstein"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Libro" => array:5 [
                        "fecha" => "2009"
                        "paginaInicial" => "277"
                        "paginaFinal" => "292"
                        "editorial" => "John Wiley &#38; Sons&#44; Ltd"
                        "editorialLocalizacion" => "West Sussex&#44; UK"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            25 => array:3 [
              "identificador" => "bib0026"
              "etiqueta" => "26"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Sensitivity analysis and diagnostics"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "J&#46;B&#46; Greenhouse"
                            1 => "S&#46; Iyengar"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "LibroEditado" => array:5 [
                        "editores" => "HCooper, LVHedges, JCValentine"
                        "titulo" => "Handbook of Research Synthesis and Meta-Analysis"
                        "paginaInicial" => "417"
                        "paginaFinal" => "434"
                        "serieFecha" => "2009"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            26 => array:3 [
              "identificador" => "bib0027"
              "etiqueta" => "27"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Subgroup Analyses&#46; Introduction to Meta-Analysis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "M&#46;B&#46; LVH"
                            1 => "J&#46;P&#46;T&#46; Higgins"
                            2 => "H&#46;R&#46; Rothstein"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Libro" => array:5 [
                        "fecha" => "2009"
                        "paginaInicial" => "149"
                        "paginaFinal" => "186"
                        "editorial" => "John Wiley &#38; Sons&#44; Ltd"
                        "editorialLocalizacion" => "West Sussex&#44; UK"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            27 => array:3 [
              "identificador" => "bib0028"
              "etiqueta" => "28"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Meta-Regression"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "M&#46;B&#46; LVH"
                            1 => "J&#46;P&#46;T&#46; Higgins"
                            2 => "H&#46;R&#46; Rothstein"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Libro" => array:6 [
                        "titulo" => "Introduction to Meta-Analysis"
                        "fecha" => "2009"
                        "paginaInicial" => "187"
                        "paginaFinal" => "203"
                        "editorial" => "John Wiley &#38; Sons&#44; Ltd"
                        "editorialLocalizacion" => "West Sussex&#44; UK"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            28 => array:3 [
              "identificador" => "bib0029"
              "etiqueta" => "29"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Differential increase in prevalence estimates of inadequate sleep among black and white Americans"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "G&#46; Jean-Louis"
                            1 => "M&#46;A&#46; Grandner"
                            2 => "S&#46;D&#46; Youngstedt"
                            3 => "N&#46;J&#46; Williams"
                            4 => "F&#46; Zizi"
                            5 => "D&#46;F&#46; Sarpong"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:4 [
                        "tituloSerie" => "BMC Public Health"
                        "fecha" => "2015"
                        "volumen" => "15"
                        "paginaInicial" => "1185"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            29 => array:3 [
              "identificador" => "bib0030"
              "etiqueta" => "30"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Racial differences in sleep architecture&#58; the role of ethnic discrimination"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "L&#46; Tomfohr"
                            1 => "M&#46;A&#46; Pung"
                            2 => "K&#46;M&#46; Edwards"
                            3 => "J&#46;E&#46; Dimsdale"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.biopsycho.2011.09.002"
                      "Revista" => array:7 [
                        "tituloSerie" => "Biol Psychol"
                        "fecha" => "2012"
                        "volumen" => "89"
                        "numero" => "1"
                        "paginaInicial" => "34"
                        "paginaFinal" => "38"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21925567"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            30 => array:3 [
              "identificador" => "bib0031"
              "etiqueta" => "31"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Aging and changing patterns of alcohol use"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "R&#46;G&#46; Dunham"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1080/02791072.1981.10524296"
                      "Revista" => array:7 [
                        "tituloSerie" => "J Psychoactive Drugs"
                        "fecha" => "1981"
                        "volumen" => "13"
                        "numero" => "2"
                        "paginaInicial" => "143"
                        "paginaFinal" => "151"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7299534"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            31 => array:3 [
              "identificador" => "bib0032"
              "etiqueta" => "32"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A contingency management method for 30-days abstinence in non-treatment seeking young adult cannabis users"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "R&#46;M&#46; Schuster"
                            1 => "A&#46; Hanly"
                            2 => "J&#46; Gilman"
                            3 => "A&#46; Budney"
                            4 => "R&#46; Vandrey"
                            5 => "A&#46;E&#46; Evins"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.drugalcdep.2016.08.622"
                      "Revista" => array:6 [
                        "tituloSerie" => "Drug Alcohol Depend"
                        "fecha" => "2016"
                        "volumen" => "167"
                        "paginaInicial" => "199"
                        "paginaFinal" => "206"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27590742"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            32 => array:3 [
              "identificador" => "bib0033"
              "etiqueta" => "33"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "GRADE&#58; an emerging consensus on rating quality of evidence and strength of recommendations"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "G&#46;H&#46; Guyatt"
                            1 => "A&#46;D&#46; Oxman"
                            2 => "G&#46;E&#46; Vist"
                            3 => "R&#46; Kunz"
                            4 => "Y&#46; Falck-Ytter"
                            5 => "P&#46; Alonso-Coello"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1136/bmj.39489.470347.AD"
                      "Revista" => array:7 [
                        "tituloSerie" => "BMJ"
                        "fecha" => "2008"
                        "volumen" => "336"
                        "numero" => "7650"
                        "paginaInicial" => "924"
                        "paginaFinal" => "926"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18436948"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            33 => array:3 [
              "identificador" => "bib0034"
              "etiqueta" => "34"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Polysomnographic and spectral sleep EEG in primary alcoholics&#58; an interaction between alcohol dependence and African-American ethnicity"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "M&#46; Irwin"
                            1 => "C&#46; Miller"
                            2 => "J&#46;C&#46; Gillin"
                            3 => "A&#46; Demodena"
                            4 => "C&#46;L&#46; Ehlers"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:7 [
                        "tituloSerie" => "Alcohol Clin Exp Res"
                        "fecha" => "2000"
                        "volumen" => "24"
                        "numero" => "9"
                        "paginaInicial" => "1376"
                        "paginaFinal" => "1384"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11003203"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            34 => array:3 [
              "identificador" => "bib0035"
              "etiqueta" => "35"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Periodic limb movements during sleep in alcohol dependent patients"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "H&#46; Gann"
                            1 => "B&#46; Feige"
                            2 => "S&#46; Fasihi"
                            3 => "D&#46; van Calker"
                            4 => "U&#46; Voderholzer"
                            5 => "D&#46; Riemann"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur Arch Psychiatry Clin Neurosci"
                        "fecha" => "2002"
                        "volumen" => "252"
                        "numero" => "3"
                        "paginaInicial" => "124"
                        "paginaFinal" => "129"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            35 => array:3 [
              "identificador" => "bib0036"
              "etiqueta" => "36"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Abnormal nocturnal melatonin secretion and disordered sleep in abstinent alcoholics"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "E&#46; K&#252;hlwein"
                            1 => "R&#46;L&#46; Hauger"
                            2 => "M&#46;R&#46; Irwin"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/s0006-3223(03)00005-2"
                      "Revista" => array:7 [
                        "tituloSerie" => "Biol Psychiatry"
                        "fecha" => "2003"
                        "volumen" => "54"
                        "numero" => "12"
                        "paginaInicial" => "1437"
                        "paginaFinal" => "1443"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/14675809"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            36 => array:3 [
              "identificador" => "bib0037"
              "etiqueta" => "37"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Disordered sleep&#44; nocturnal cytokines&#44; and immunity in alcoholics"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "L&#46; Redwine"
                            1 => "J&#46; Dang"
                            2 => "M&#46; Hall"
                            3 => "M&#46; Irwin"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1097/01.psy.0000038943.33335.d2"
                      "Revista" => array:7 [
                        "tituloSerie" => "Psychosom Med"
                        "fecha" => "2003"
                        "volumen" => "65"
                        "numero" => "1"
                        "paginaInicial" => "75"
                        "paginaFinal" => "85"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12554818"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            37 => array:3 [
              "identificador" => "bib0038"
              "etiqueta" => "38"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Association between nocturnal vagal tone and sleep depth&#44; sleep quality&#44; and fatigue in alcohol dependence"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "M&#46;R&#46; Irwin"
                            1 => "E&#46;M&#46; Valladares"
                            2 => "S&#46; Motivala"
                            3 => "J&#46;F&#46; Thayer"
                            4 => "C&#46;L&#46; Ehlers"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1097/01.psy.0000195743.60952.00"
                      "Revista" => array:7 [
                        "tituloSerie" => "Psychosom Med"
                        "fecha" => "2006"
                        "volumen" => "68"
                        "numero" => "1"
                        "paginaInicial" => "159"
                        "paginaFinal" => "166"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16449427"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            38 => array:3 [
              "identificador" => "bib0039"
              "etiqueta" => "39"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Impact of alcoholism on sleep architecture and EEG power spectra in men and women"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "I&#46;M&#46; Colrain"
                            1 => "S&#46; Turlington"
                            2 => "F&#46;C&#46; Baker"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1093/sleep/32.10.1341"
                      "Revista" => array:7 [
                        "tituloSerie" => "Sleep"
                        "fecha" => "2009"
                        "volumen" => "32"
                        "numero" => "10"
                        "paginaInicial" => "1341"
                        "paginaFinal" => "1352"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19848363"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            39 => array:3 [
              "identificador" => "bib0040"
              "etiqueta" => "40"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Sleep architecture in adolescent marijuana and alcohol users during acute and extended abstinence"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46; Cohen-Zion"
                            1 => "S&#46;P&#46;A&#46; Drummond"
                            2 => "C&#46;B&#46; Padula"
                            3 => "J&#46; Winward"
                            4 => "J&#46; Kanady"
                            5 => "K&#46;L&#46; Medina"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.addbeh.2009.05.011"
                      "Revista" => array:7 [
                        "tituloSerie" => "Addict Behav"
                        "fecha" => "2009"
                        "volumen" => "34"
                        "numero" => "11"
                        "paginaInicial" => "976"
                        "paginaFinal" => "979"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19505769"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            40 => array:3 [
              "identificador" => "bib0041"
              "etiqueta" => "41"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Sleep in women&#58; normal values for sleep stages and position and the effect of age&#44; obesity&#44; sleep apnea&#44; smoking&#44; alcohol and hypertension"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "C&#46; Sahlin"
                            1 => "K&#46;A&#46; Franklin"
                            2 => "H&#46; Stenlund"
                            3 => "E&#46; Lindberg"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.sleep.2008.12.008"
                      "Revista" => array:7 [
                        "tituloSerie" => "Sleep Med"
                        "fecha" => "2009"
                        "volumen" => "10"
                        "numero" => "9"
                        "paginaInicial" => "1025"
                        "paginaFinal" => "1030"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19345643"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            41 => array:3 [
              "identificador" => "bib0042"
              "etiqueta" => "42"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Poor autonomic nervous system functioning during sleep in recently detoxified alcohol-dependent men and women"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "M&#46; de Zambotti"
                            1 => "F&#46;C&#46; Baker"
                            2 => "D&#46;S&#46; Sugarbaker"
                            3 => "C&#46;L&#46; Nicholas"
                            4 => "J&#46; Trinder"
                            5 => "I&#46;M&#46; Colrain"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/acer.12384"
                      "Revista" => array:7 [
                        "tituloSerie" => "Alcohol Clin Exp Res"
                        "fecha" => "2014"
                        "volumen" => "38"
                        "numero" => "5"
                        "paginaInicial" => "1373"
                        "paginaFinal" => "1380"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24575956"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            42 => array:3 [
              "identificador" => "bib0043"
              "etiqueta" => "43"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Sleep&#44; sleep homeostasis and arousal disturbances in alcoholism"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "R&#46; Sharma"
                            1 => "M&#46; Parikh"
                            2 => "V&#46; Mishra"
                            3 => "A&#46; Zuniga"
                            4 => "P&#46; Sahota"
                            5 => "M&#46; Thakkar"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.brainresbull.2022.01.022"
                      "Revista" => array:6 [
                        "tituloSerie" => "Brain Res Bull"
                        "fecha" => "2022"
                        "volumen" => "182"
                        "paginaInicial" => "30"
                        "paginaFinal" => "43"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/35122900"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            43 => array:3 [
              "identificador" => "bib0044"
              "etiqueta" => "44"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Alcohol-use disorders"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "M&#46;A&#46; Schuckit"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Lancet"
                        "fecha" => "2009"
                        "volumen" => "373"
                        "numero" => "9662"
                        "paginaInicial" => "492"
                        "paginaFinal" => "501"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            44 => array:3 [
              "identificador" => "bib0045"
              "etiqueta" => "45"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Prevalence and correlates of withdrawal-related insomnia among adults with alcohol dependence&#58; results from a national survey"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "K&#46;J&#46; Brower"
                            1 => "B&#46;E&#46; Perron"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Am J Addict"
                        "fecha" => "2010"
                        "volumen" => "19"
                        "numero" => "3"
                        "paginaInicial" => "238"
                        "paginaFinal" => "244"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            45 => array:3 [
              "identificador" => "bib0046"
              "etiqueta" => "46"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Sleep in alcoholic patients&#58; longitudinal findings"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "O&#46;H&#46; Rundell"
                            1 => "H&#46;L&#46; Williams"
                            2 => "B&#46;K&#46; Lester"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Adv Exp Med Biol"
                        "fecha" => "1977"
                        "volumen" => "85B"
                        "paginaInicial" => "389"
                        "paginaFinal" => "402"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            46 => array:3 [
              "identificador" => "bib0047"
              "etiqueta" => "47"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Sleep patterns of sober chronic alcoholics"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "S&#46; Snyder"
                            1 => "I&#46; Karacan"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:4 [
                        "tituloSerie" => "Neuropsychobiology"
                        "fecha" => "1985"
                        "volumen" => "13"
                        "numero" => "1&#8211;2"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            47 => array:3 [
              "identificador" => "bib0048"
              "etiqueta" => "48"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Polygraphic sleep measures differentiate alcoholics and stimulant abusers during short-term abstinence"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "P&#46;M&#46; Thompson"
                            1 => "J&#46;C&#46; Gillin"
                            2 => "S&#46; Golshan"
                            3 => "M&#46; Irwin"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/0006-3223(95)00070-4"
                      "Revista" => array:7 [
                        "tituloSerie" => "Biol Psychiatry"
                        "fecha" => "1995"
                        "volumen" => "38"
                        "numero" => "12"
                        "paginaInicial" => "831"
                        "paginaFinal" => "836"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8750043"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            48 => array:3 [
              "identificador" => "bib0049"
              "etiqueta" => "49"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Altered sleep physiology in chronic alcoholics&#58; reversal with abstinence"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "H&#46;L&#46; Williams"
                            1 => "O&#46;H&#46; Rundell"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/j.1530-0277.1981.tb04905.x"
                      "Revista" => array:7 [
                        "tituloSerie" => "Alcohol Clin Exp Res"
                        "fecha" => "1981"
                        "volumen" => "5"
                        "numero" => "2"
                        "paginaInicial" => "318"
                        "paginaFinal" => "325"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7018314"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            49 => array:3 [
              "identificador" => "bib0050"
              "etiqueta" => "50"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Prevalence&#44; correlates&#44; disability&#44; and comorbidity of DSM-IV alcohol abuse and dependence in the United States&#58; results from the National Epidemiologic Survey on Alcohol and Related Conditions"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "D&#46;S&#46; Hasin"
                            1 => "F&#46;S&#46; Stinson"
                            2 => "E&#46; Ogburn"
                            3 => "B&#46;F&#46; Grant"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Arch Gen Psychiatry"
                        "fecha" => "2007"
                        "volumen" => "64"
                        "numero" => "7"
                        "paginaInicial" => "830"
                        "paginaFinal" => "842"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            50 => array:3 [
              "identificador" => "bib0051"
              "etiqueta" => "51"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Recovery from DSM-IV alcohol dependence&#58; united States&#44; 2001-2002"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "D&#46;A&#46; Dawson"
                            1 => "B&#46;F&#46; Grant"
                            2 => "F&#46;S&#46; Stinson"
                            3 => "P&#46;S&#46; Chou"
                            4 => "B&#46; Huang"
                            5 => "W&#46;J&#46; Ruan"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/j.1360-0443.2004.00964.x"
                      "Revista" => array:7 [
                        "tituloSerie" => "Addiction"
                        "fecha" => "2005"
                        "volumen" => "100"
                        "numero" => "3"
                        "paginaInicial" => "281"
                        "paginaFinal" => "292"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15733237"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            51 => array:3 [
              "identificador" => "bib0052"
              "etiqueta" => "52"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A multilevel decomposition approach to estimate the role of program location and neighborhood disadvantage in racial disparities in alcohol treatment completion"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "J&#46;O&#46; Jacobson"
                            1 => "P&#46; Robinson"
                            2 => "R&#46;N Bluthenthal"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.socscimed.2006.08.032"
                      "Revista" => array:7 [
                        "tituloSerie" => "Soc Sci Med"
                        "fecha" => "2007"
                        "volumen" => "64"
                        "numero" => "2"
                        "paginaInicial" => "462"
                        "paginaFinal" => "476"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17055634"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            52 => array:3 [
              "identificador" => "bib0053"
              "etiqueta" => "53"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Racial&#47;ethnic discrimination and alcohol use disorder severity among United States adults"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "J&#46;E&#46; Glass"
                            1 => "E&#46;C&#46; Williams"
                            2 => "H&#46; Oh"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:3 [
                        "tituloSerie" => "Drug Alcohol Depend"
                        "fecha" => "2020"
                        "volumen" => "216"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            53 => array:3 [
              "identificador" => "bib0054"
              "etiqueta" => "54"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Disparities in sleep characteristics by race&#47;ethnicity in a population-based sample&#58; chicago Area Sleep Study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46;R&#46; Carnethon"
                            1 => "P&#46;J&#46; De Chavez"
                            2 => "P&#46;C&#46; Zee"
                            3 => "K&#46;-Y&#46;A&#46; Kim"
                            4 => "K&#46; Liu"
                            5 => "J&#46;J&#46; Goldberger"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.sleep.2015.07.005"
                      "Revista" => array:6 [
                        "tituloSerie" => "Sleep Med"
                        "fecha" => "2016"
                        "volumen" => "18"
                        "paginaInicial" => "50"
                        "paginaFinal" => "55"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26459680"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            54 => array:3 [
              "identificador" => "bib0055"
              "etiqueta" => "55"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Ethnic differences in sleep duration and morning-evening type in a population sample"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "S&#46;K&#46; Malone"
                            1 => "F&#46; Patterson"
                            2 => "Y&#46; Lu"
                            3 => "A&#46; Lozano"
                            4 => "A&#46; Hanlon"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3109/07420528.2015.1107729"
                      "Revista" => array:7 [
                        "tituloSerie" => "Chronobiol Int"
                        "fecha" => "2016"
                        "volumen" => "33"
                        "numero" => "1"
                        "paginaInicial" => "10"
                        "paginaFinal" => "21"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26654569"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            55 => array:3 [
              "identificador" => "bib0056"
              "etiqueta" => "56"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Gender differences in the relationship between alcohol consumption and drink problems are largely accounted for by body water"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "M&#46; Ely"
                            1 => "R&#46; Hardy"
                            2 => "N&#46;T&#46; Longford"
                            3 => "M&#46;E Wadsworth"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1093/alcalc/34.6.894"
                      "Revista" => array:7 [
                        "tituloSerie" => "Alcohol Alcohol"
                        "fecha" => "1999"
                        "volumen" => "34"
                        "numero" => "6"
                        "paginaInicial" => "894"
                        "paginaFinal" => "902"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10659726"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            56 => array:3 [
              "identificador" => "bib0057"
              "etiqueta" => "57"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Sex Differences in Alcohol Use Disorder"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "R&#46; Agabio"
                            1 => "C&#46; Pisanu"
                            2 => "G&#46;L&#46; Gessa"
                            3 => "F&#46; Franconi"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Curr Med Chem"
                        "fecha" => "2017"
                        "volumen" => "24"
                        "numero" => "24"
                        "paginaInicial" => "2661"
                        "paginaFinal" => "2670"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            57 => array:3 [
              "identificador" => "bib0058"
              "etiqueta" => "58"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Quality of life in alcohol misuse&#58; comparison of men and women"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "T&#46;J&#46; Peters"
                            1 => "L&#46;M&#46; Millward"
                            2 => "J&#46; Foster"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s00737-003-0012-x"
                      "Revista" => array:7 [
                        "tituloSerie" => "Arch Womens Ment Health"
                        "fecha" => "2003"
                        "volumen" => "6"
                        "numero" => "4"
                        "paginaInicial" => "239"
                        "paginaFinal" => "243"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/14628175"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            58 => array:3 [
              "identificador" => "bib0059"
              "etiqueta" => "59"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Sleep problems in the elderly"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "J&#46;C&#46; Rodriguez"
                            1 => "J&#46;M&#46; Dzierzewski"
                            2 => "C&#46;A&#46; Alessi"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.mcna.2014.11.013"
                      "Revista" => array:7 [
                        "tituloSerie" => "Med Clin North Am"
                        "fecha" => "2015"
                        "volumen" => "99"
                        "numero" => "2"
                        "paginaInicial" => "431"
                        "paginaFinal" => "439"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25700593"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            59 => array:3 [
              "identificador" => "bib0060"
              "etiqueta" => "60"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:1 [
                      "titulo" => "Population-level risks of alcohol consumption by amount&#44; geography&#44; age&#44; sex&#44; and year&#58; a systematic analysis for the Global Burden of Disease Study 2020"
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/S0140-6736(22)00847-9"
                      "Revista" => array:7 [
                        "tituloSerie" => "Lancet"
                        "fecha" => "2022"
                        "volumen" => "400"
                        "numero" => "10347"
                        "paginaInicial" => "185"
                        "paginaFinal" => "235"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/35843246"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            60 => array:3 [
              "identificador" => "bib0061"
              "etiqueta" => "61"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Insomnia in the elderly&#58; a review"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "D&#46; Patel"
                            1 => "J&#46; Steinberg"
                            2 => "P&#46; Patel"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.5664/jcsm.7172"
                      "Revista" => array:7 [
                        "tituloSerie" => "J Clin Sleep Med"
                        "fecha" => "2018"
                        "volumen" => "14"
                        "numero" => "6"
                        "paginaInicial" => "1017"
                        "paginaFinal" => "1024"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/29852897"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            61 => array:3 [
              "identificador" => "bib0062"
              "etiqueta" => "62"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Sleep abnormalities during abstinence in alcohol-dependent patients&#46; Aetiology and management"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "H&#46;P&#46; Landolt"
                            1 => "J&#46;C&#46; Gillin"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.2165/00023210-200115050-00006"
                      "Revista" => array:7 [
                        "tituloSerie" => "CNS Drugs"
                        "fecha" => "2001"
                        "volumen" => "15"
                        "numero" => "5"
                        "paginaInicial" => "413"
                        "paginaFinal" => "425"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11475945"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            62 => array:3 [
              "identificador" => "bib0063"
              "etiqueta" => "63"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "EEG sleep studies in &#34;pure&#34; primary alcoholism during subacute withdrawal&#58; relationships to normal controls&#44; age&#44; and other clinical variables"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "J&#46;C&#46; Gillin"
                            1 => "T&#46;L&#46; Smith"
                            2 => "M&#46; Irwin"
                            3 => "D&#46;F&#46; Kripke"
                            4 => "M&#46; Schuckit"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/0006-3223(90)90439-9"
                      "Revista" => array:7 [
                        "tituloSerie" => "Biol Psychiatry"
                        "fecha" => "1990"
                        "volumen" => "27"
                        "numero" => "5"
                        "paginaInicial" => "477"
                        "paginaFinal" => "488"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/2310803"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            63 => array:3 [
              "identificador" => "bib0064"
              "etiqueta" => "64"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Alcohol use disorder and sleep disturbances&#58; a feed-forward allostatic framework"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "G&#46;F&#46; Koob"
                            1 => "I&#46;M&#46; Colrain"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1038/s41386-019-0446-0"
                      "Revista" => array:7 [
                        "tituloSerie" => "Neuropsychopharmacology"
                        "fecha" => "2020"
                        "volumen" => "45"
                        "numero" => "1"
                        "paginaInicial" => "141"
                        "paginaFinal" => "165"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/31234199"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            64 => array:3 [
              "identificador" => "bib0065"
              "etiqueta" => "65"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "EEG power spectral analysis of abnormal cortical activations during REM&#47;NREM sleep in obstructive sleep apnea"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "S&#46; Liu"
                            1 => "J&#46; Shen"
                            2 => "Y&#46; Li"
                            3 => "J&#46; Wang"
                            4 => "J&#46; Wang"
                            5 => "J&#46; Xu"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:3 [
                        "tituloSerie" => "Front Neurol"
                        "fecha" => "2021"
                        "volumen" => "12"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            65 => array:3 [
              "identificador" => "bib0066"
              "etiqueta" => "66"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Cardiac autonomic function during sleep&#58; effects of alcohol dependence and evidence of partial recovery with abstinence"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "M&#46; de Zambotti"
                            1 => "A&#46;R&#46; Willoughby"
                            2 => "F&#46;C&#46; Baker"
                            3 => "D&#46;S&#46; Sugarbaker"
                            4 => "I&#46;M&#46; Colrain"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.alcohol.2014.07.023"
                      "Revista" => array:7 [
                        "tituloSerie" => "Alcohol"
                        "fecha" => "2015"
                        "volumen" => "49"
                        "numero" => "4"
                        "paginaInicial" => "409"
                        "paginaFinal" => "415"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25957854"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
    "agradecimientos" => array:1 [
      0 => array:4 [
        "identificador" => "xack736522"
        "titulo" => "Funding"
        "texto" => "<p id="para0038" class="elsevierStylePara elsevierViewall">This work was supported by grants from Discipline Leader of the Three-Year Action Plan for the <span class="elsevierStyleGrantSponsor" id="gs0001">Construction of Public Health System in Shanghai</span> &#40;Psychology and Mental Health&#44; <span class="elsevierStyleGrantNumber" refid="gs0001">GWV-10&#46; 2-XD26</span>&#41; and <span class="elsevierStyleGrantSponsor" id="gs0002">Shanghai Clinical Research Center for Mental Health</span> &#40;<span class="elsevierStyleGrantNumber" refid="gs0002">19MC1911100</span>&#41;&#46;</p>"
        "vista" => "all"
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/02136163/0000003800000002/v1_202403290827/S0213616323000447/v1_202403290827/en/main.assets"
  "Apartado" => array:4 [
    "identificador" => "64426"
    "tipo" => "SECCION"
    "en" => array:2 [
      "titulo" => "Original articles"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "en"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/02136163/0000003800000002/v1_202403290827/S0213616323000447/v1_202403290827/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0213616323000447?idApp=UINPBA00004N"
]
Article information
ISSN: 02136163
Original language: English
The statistics are updated each day

Follow this link to access the full text of the article

es en pt

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?

Você é um profissional de saúde habilitado a prescrever ou dispensar medicamentos