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Understanding and managing sleep problems related to alcohol abuse

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February 28, 2021
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Understanding and managing sleep problems related to alcohol abuse
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Many people with alcohol use disorders also have trouble sleeping. They can easily fall asleep, but excessive alcohol consumption disrupts their sleep for the last half of the night.

If you also drink too much occasionally, you are likely to have trouble sleeping. “Having three or more drinks causes the average person to fall asleep earlier than usual,” says Shawn R. Currie of the University of Calgary. “Falling asleep faster, however, is the only real benefit of alcohol for sleeping.” If you stop drinking and stay sober, you can have significant sleep problems long after you stop drinking.

Most heavy drinkers who stop drinking have difficulty sleeping in the early days of sobriety. It’s one of the most common alcohol withdrawal symptoms and causes relapse.

Typical recovery sleep issues

According to the Agency for Substance Abuse and Mental Health (SAMHSA), 25% to 72% of people with alcohol use disorders report having trouble sleeping. More common, disruptive effects include waking more often, poorer quality of sleep, decreased deep sleep, and waking up earlier than usual, which can make people feel like they are not getting enough sleep...

Studies have shown that:

  • Insomnia can persist for many months after you stop drinking...
  • Alcoholics who are recovering usually have more trouble getting to sleep than maintaining sleep...
  • Many recovering alcoholics have had sleep problems that arose before their alcohol addiction...

Research also shows that sleep disorders can linger long after the alcohol withdrawal symptoms have ended. They can continue to occur during the two to six months of abstinence following withdrawal. Currie notes that recovery and abstinence are more of a challenge when you are unable to get a good night’s sleep...

Alcohol use and sleep disorders

Not restful sleep

People recovering from alcohol take a long time to fall asleep, have trouble sleeping through the night, and feel that their sleep is unrefreshing...

Laboratory studies show reductions in deep sleep and abnormalities in REM sleep in people who have been sober for more than a year. REM sleep is characterized by increased brain activity, relaxation of the body, rapid eye movements and increased dreaming.

“Sleep has a reputation in the recovering community as one of the last things to fall behind for an individual,” said David Hodgins, professor of psychology at the University of Calgary. “It is also recognized as a potential relapse trigger.

There is a little saying within the 12-step community that describes the risk factors for relapse. it’s called STOP. People who are hungry, angry, lonely, or tired are at increased risk of relapse. One way a person can be tired is with difficulty sleeping. ”

insomnia

The researchers found that alcoholics with short- and long-term abstinence had similarly disturbed sleep after they stopped drinking. In general, the problems with onset of sleep were worse than with maintaining sleep...

Types of insomnia

  • insomnia: Problems falling asleep
  • Maintenance insomnia: Inability to sleep through the night (waking up and not being able to go back to sleep)
  • Acute insomnia: Brief sleep disorders, often caused by a stressful life event or experience
  • Chronic insomnia: Problems falling or sleeping at least three nights a week for three months or more
  • Comorbid insomnia: Occurs with another condition, such as depression or anxiety, that also interferes with sleep

Many people with recovering insomnia also had insomnia before they became addicted to alcohol. Currie notes that chronic insomnia affects 10% to 15% of the adult population, but half of his study participants had insomnia before they became addicted to alcohol. “While we cannot deduce a causal relationship between insomnia and alcoholism from these data, it is difficult to ignore such a high rate of pre-existing sleep problems in the sample,” he says...

Treatment of insomnia

The first treatment for insomnia on recovery is fasting, and many patients will see improvement. For the specific treatment of insomnia, behavioral therapies are the preferred treatment (rather than medication) because they have been shown to be effective and do not affect sobriety...

Cognitive behavioral therapy for insomnia (CBT-I)

The goal of cognitive behavioral therapy for insomnia (CBT-I) is to change sleep habits, as well as any misunderstandings about sleep and insomnia that can lead to insomnia. CBT-I often includes regular weekly meetings where your therapist gives you sleep assessments, works with you to change problematic sleep patterns, and asks you to keep a sleep diary at home.

Restricting sleep

This type of behavior therapy improves your sleep efficiency, or the time you spend sleeping divided by the time you spend in bed. The idea behind sleep restriction is that by limiting the amount of time you allow yourself to sleep and stay in bed, you will increase your cravings for sleep (called the sleep drive) and sleep less restlessly and more efficiently.

medication

There are many drugs available to treat insomnia, including benzodiazepines and non-benzodiazepines. When you are in recovery, your doctor must weigh the risks and benefits of prescribing these insomnia medications. There are also some relapse prevention medications that can promote sleep...

Complementary Therapy

Numerous complementary therapies have been used to treat insomnia in people in recovery, including:

  • Relaxation and biofeedback therapy
  • Progressive Muscle Relaxation
  • yoga
  • Aromatherapy
  • Mindfulness meditation

Sleep hygiene

Working on your sleep hygiene is another way to prevent or reduce insomnia. These are changes you can make to your surroundings and routine to promote sleep.

  • Develop a relaxing bedtime. Whether you’re writing in a journal, using a meditation app, or relaxing with a warm bath, something calming before turning off the lights will help set the tone for sound sleep.
  • Keep your room dark, cool, and comfortable. Avoid using televisions, cell phones, computers, or e-readers in your bedroom. The blue light from these electronic devices can suppress the body’s sleep-inducing hormone melatonin and disrupt your internal clock. The National Sleep Foundation recommends keeping your room cool (about 65 degrees Fahrenheit) and using light blocking drapes, shades, or blinds to keep your bedroom dark...
  • Maintain a regular sleep / wake schedule. This allows your body to get used to a specific bedtime time and then be ready to sleep at that time.
  • Avoid naps. Naps decrease your overall sleep debt and make it harder to get back to sleep at the right time at night.
  • Stop using stimulants in the evening. Stimulants that disrupt sleep are caffeine (coffee, tea, soft drinks, chocolate) and nicotine. According to a study published in Psychology, Health & MedicineThe average person loses more than a minute of sleep for every cigarette they smoke...

If you or a loved one is struggling with substance use or addiction problems, contact the National Substance Abuse and Mental Health Authority (SAMHSA) helpline at 1-800-662-4357 Information about support and treatment facilities in your area.

Additional mental health resources can be found in our National Helpline Database.



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