Sleep Problems Associated With Alcohol Misuse

Alcohol is often seen as a quick fix when you can’t sleep. Many people think a nightcap can take the edge off and help ease the mind into sleep. The problem is that while it might sometimes help you fall asleep faster, the long-term relationship between alcohol and sleep is a lot more complicated.

Many people with alcohol use disorders also have sleep problems. If you drink to excess, even occasionally, you have probably experienced sleep problems.

Such problems can persist for some time even after you decide to quit drinking. Difficulty sleeping is one of the most common alcohol withdrawal symptoms and one that causes many to relapse. Alcohol can create havoc when it comes to getting a good night’s rest by disrupting sleep cycles and increasing your risk for insomnia.

Types of Alcohol-Related Sleep Problems

Studies estimate that 36% to 91% of people with alcohol use disorder experience sleep troubles. The more prevalent, disruptive effects include:

• More frequent awakenings
• Worse sleep quality
• Reduction of deep sleep
• Earlier-than-usual waking times

The result? People often feel like they didn’t get enough sleep. They wake up exhausted and then drag through the day with daytime sleepiness, reduced concentration, irritability, and other symptoms.

Studies have found that sleep problems can last for weeks, months, or even years after quitting drinking. In many cases, people recovering from alcohol use typically have more problems with sleep onset than with sleep maintenance. In other words, while they can often stay asleep all night, they have significant problems actually falling asleep.

Unfortunately, recovery and abstinence are more challenging if you aren’t able to get enough good-quality sleep. Difficulty sleeping, particularly when a person feels that they can’t sleep sober, may increase the risk that they will relapse.

Alcohol and Non-Restorative Sleep

People in alcohol recovery take a long time to fall asleep, have problems sleeping through the night, and feel that their sleep is not restorative.

Sleep problems are often viewed as one of the last things to improve among people in alcohol recovery. It is also a symptom that poses a significant risk for relapse.

In fact, 12-step recovery programs often refer to the factors that increase a person’s risk for relapse as HALT, standing for Hungry, Angry, Lonely, or Tired. Sleep disruptions may increase the risk that a person will feel tired, which might cause a person to reach for a drink if they feel like they can sleep sober.

Alcohol and Insomnia

Insomnia is a common problem for many adults, but it is not uncommon to experience it in the short term and long term after quitting drinking. It is characterized by difficulty falling or staying asleep, which can lead to daytime drowsiness, trouble concentrating, and other negative health effects.

Insomnia is also common among people who have an alcohol use disorder, but the problem can persist or even begin during recovery. However, it is also important to note that many people experiencing insomnia during withdrawal and recovery also had insomnia before they became dependent on alcohol.

Treatment for Insomnia

The first treatment for insomnia in recovery is sobriety, and many patients will see improvement. For the specific treatment of insomnia, behavioral therapies are the preferred treatment (rather than medications), as they are effective and they won’t interfere with 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 misconceptions about sleep and insomnia that may perpetuate sleep difficulties.

Sleep Restriction

This type of behavioral therapy works to improve your sleep efficiency, or the time you spend asleep 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’ll increase your desire to sleep (called sleep drive) and sleep less fitfully and more efficiently.

Medication

There are many medications used to treat insomnia, including benzodiazepine and nonbenzodiazepine medications. If you’re in recovery, your healthcare provider will need to weigh the risks and benefits of prescribing these medications for insomnia. There are also some relapse-prevention medications that can help promote sleep.

Complementary Therapy

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

Coping With Alcohol-Related Sleep Problems

Working on your sleep hygiene is another way to help prevent or reduce insomnia. Sleep hygiene refers to healthy habits and changes you can make to your environment and routine to help promote sleep.

• Develop a relaxing bedtime routine. Whether you write in a journal, use a meditation app, or wind down with a warm bath, doing something calming before lights out will help set the tone for solid slumber.
• 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 interfere with your internal body clock. The National Sleep Foundation recommends keeping your room cool (around 65 degrees Fahrenheit) and using light-blocking curtains, shades, or blinds to keep your bedroom dark.
• Keep a regular sleep/wake schedule. This will enable your body to get used to a certain bedtime and then be ready to sleep at that time.
• Avoid napping. Naps decrease your overall amount of sleep debt, making it more difficult to fall asleep again at night at the proper time. 
• Refrain from stimulants in the evening. Stimulants that disrupt sleep include caffeine (coffee, tea, soft drinks, chocolate) and nicotine. Research has found that people who smoke have more sleep problems, including sleep disordered breathing, sleep apnea, and worse sleep quality.

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Takeaways

Alcohol can have a detrimental impact on sleep, but these problems can also persist once you decide to stop drinking. Finding ways to cope with insomnia and other sleep issues is important since poor sleep can be a risk factor for alcohol relapse.

Fortunately, there are treatments and coping techniques that can help you get better rest, which can help you feel better during alcohol recovery. If you are experiencing sleep problems, be sure to talk to your doctor about your options.