Alcohol use disorder can have a significant impact on sleep, often causing insomnia due to the way it affects the body’s sleep-wake cycle and production of melatonin. This can have serious consequences for overall health and well-being.
It is important for individuals struggling with co-occurring insomnia and alcohol use disorder (AUD) to seek help from an addiction treatment professional in order to address underlying issues and find effective treatment options.
What Is Insomnia?
Insomnia is a sleep disorder that involves chronic difficulty falling or staying asleep. People with insomnia may have trouble with the following:
- Falling asleep
- Waking up often throughout the night
- Waking up too early in the morning and being unable to fall back asleep
- Feeling fatigue and unrested after sleeping
Insomnia can have a significant impact on a person’s life and health, causing difficulties that may include the following:
- Fatigue and difficulty functioning during the day: Insomnia can lead to feelings of tiredness and lack of energy, which can affect a person’s ability to concentrate, make decisions, and complete tasks. It can also increase the potential for accidents and injuries.
- Mood problems: Insomnia can contribute to feelings of irritability, anxiety, and depression.
- Health problems: Chronic insomnia can increase the risk of developing certain medical conditions, such as high blood pressure, heart disease, diabetes, and stroke. It can also worsen the symptoms of existing health problems.
- Poor quality of life: Insomnia can negatively impact a person’s overall quality of life, including their relationships, work, and social activities.
How Does Insomnia Affect Sleep?
Insomnia is a broad term, and can manifest differently in different people. Insomnia can mean:
- Poor sleep quality: Insomnia can disrupt the normal sleep cycle, leading to a lighter, less restful sleep.
- Shortened sleep duration: People with insomnia may have difficulty falling asleep or staying asleep, leading to shorter periods of sleep overall.
- Increased sleep latency: The time it takes to fall asleep may be longer for people with insomnia, leading to longer periods of lying awake in bed. Those who take longer than 20 minutes to fall asleep may be diagnosed with insomnia as a result of sleep latency.
- Daytime sleepiness: Insomnia can lead to feelings of tiredness and fatigue during the day, even after getting enough sleep at night.
- Disrupted sleep-wake cycle: Insomnia can affect the body’s natural sleep-wake cycle, leading to difficulty falling asleep and waking up at the desired time.
Insomnia & REM Sleep
Rapid eye movement (REM) sleep is a stage of sleep characterized by rapid eye movements, increased brain activity, and vivid dreaming. It usually begins with 90 minutes of falling asleep.
The REM stage of sleep is an important part of the sleep cycle, as it helps to consolidate memories, improve learning and problem-solving skills, and regulate mood. People with insomnia may experience disrupted REM sleep, which can lead to a number of negative impacts on their sleep and overall health.
These are some possible effects of disrupted REM sleep in people with insomnia:
- Difficulty falling asleep: Insomnia can disrupt the normal sleep cycle, including the transition from wakefulness to sleep, which may make it more difficult to fall asleep at night.
- Shortened REM sleep duration: People with insomnia may have shorter periods of REM sleep, which can lead to lighter, less restful sleep.
- Decreased REM sleep intensity: The brain activity and vivid dreaming that occur during REM sleep may be less intense in people with insomnia, which can affect the quality of their sleep.
- Daytime sleepiness: Insomnia can lead to feelings of fatigue and tiredness during the day, even after getting enough sleep at night.
Key Facts About Alcohol Use Disorder & Insomnia
- Among those actively in treatment for alcohol use disorder, rates of insomnia range from 36% to 72%, according to Alcohol Research & Health.
- People living with chronic alcohol use disorder are 2.6 times more likely to also struggle with insomnia compared to those who do not have a history of alcohol use disorders, according to American Journal of Addiction.
- About 10% to 15% of chronic insomnia is likely caused by an underlying substance use disorder in the U.S., according to Clinics in Geriatric Medicine.
- Chronic insomnia may increase the risk of developing an alcohol use disorder, as people may turn to alcohol as a way to cope with sleep problems.
How Does Drinking Alcohol Cause Insomnia?
There are many factors that can contribute to insomnia, and drinking alcohol regularly is one of them. While it may seem counterintuitive, alcohol is actually a sedative that can initially help a person fall asleep more quickly (shortening the time between trying to sleep and actually falling asleep, also called “sleep latency”.
However, studies show that while alcohol can sometimes decrease “sleep latency” (help people fall asleep more quickly), it actually affects the overall quality of sleep. Research shows that individuals who drink regularly have decreased time in REM sleep and other stages of sleep that are essential for the consolidation of memories and for overall daily functioning. As a result, people who are drinking may actually conversely feel more tired the next day because the quantity of their sleep was adequate but the quality of their sleep was poor.
As the body metabolizes alcohol, it releases substances called adenosine and dopamine, which can affect the body’s sleep-wake cycle. Adenosine is a neurotransmitter that helps regulate sleep, and its levels increase as the body becomes tired. Dopamine is a neurotransmitter that is associated with pleasure and reward, and its levels increase when a person drinks alcohol.
The release of these substances can cause a person to fall asleep more quickly, but it can also disrupt their sleep patterns later in the night. This can lead to fragmented sleep, with frequent awakenings or a feeling of restlessness.
Additionally, alcohol can interfere with the body’s production of melatonin, a hormone that helps regulate sleep. When a person drinks alcohol, their body may produce less melatonin, making it more difficult to fall asleep and stay asleep.
The effects of alcohol on sleep can be compounded if a person is struggling with alcohol use disorder. Heavy and chronic alcohol use can lead to a tolerance to the sedative effects of alcohol, meaning that a person may need to drink more in order to achieve the same level of relaxation and sleep. This can lead to a vicious cycle, as the person may continue to drink more in an attempt to get a good night’s sleep, but this only exacerbates the problem.
Insomnia & Alcohol Withdrawal or Detox
The negative impact of alcoholism on sleep can have serious consequences on a person’s overall health and well-being. Chronic insomnia can lead to a range of physical and mental health issues, including these:
- Difficulty concentrating
- Increased risk of developing certain conditions, such as high blood pressure and depression.
- Memory loss
- Weight gain
- Chronic pain conditions
Unfortunately, these issues can make it more difficult to manage the withdrawal symptoms that come with cessation of alcohol use. Symptoms may include the following:
- Nausea and vomiting
- Anxiety and agitation
Treatment for alcohol use disorder and insomnia may involve a combination of approaches, including medication, therapy, and lifestyle changes. It is important for people struggling with these conditions to seek help from a healthcare professional, as both alcohol use disorder and insomnia can have serious consequences if left untreated.
It is also important to make sure that both disorders are treated simultaneously since untreated insomnia can lead to a relapse in alcohol misuse, and untreated alcohol misuse can contribute to ongoing difficulties with insomnia.
Ways to Enhance Sleep & Address Insomnia
If both alcohol misuse and insomnia are an issue, it is essential to seek treatment for a team that can address both issues. However, there are a number of ways to enhance sleep while treating insomnia and alcohol use disorders. Here are some of them:
- Establish a consistent sleep schedule. Try to go to bed and wake up at the same time every day, including on weekends and holidays.
- Create a relaxing bedtime routine. Develop a routine that helps you wind down before bed, such as reading, listening to calming music, or taking a warm bath.
- Make your sleep environment comfortable. Keep your bedroom cool, dark, and quiet, and use a comfortable mattress and pillows. Turn on white noise or other soothing sounds to help block street noise or other disruptive sounds.
- Avoid screens before bedtime. The blue light emitted by screens can interfere with sleep, so try to avoid screens for at least an hour before bedtime.
- Avoid caffeine, alcohol, and large meals before bed. Of course, alcohol is off the table in recovery, but caffeine and large amounts of food can also disrupt sleep, so it’s best to avoid them close to bedtime.
- Exercise regularly. Regular physical activity earlier in the day can improve sleep quality at night, but try to avoid vigorous exercise close to bedtime, as it can make it more challenging to fall asleep.
- Practice relaxation techniques. Techniques like deep breathing, progressive muscle relaxation, and mindfulness meditation can help to relax the mind and body and improve sleep.
- Try sleep aids. If lifestyle changes are not enough to improve sleep, you may want to talk to a healthcare provider about using sleep aids or medications to manage insomnia that are non-addictive and do not interact with other medications you are taking. Medications are always seen as a short-term solution and shouldn’t be used on a long-term basis.
Better Sleep in Recovery
Alcohol use disorders can be disruptive to the ability to maintain a healthy work life, positive relationships, good health and overall well-being. They can also stop you from getting the sleep you need to feel your best.
If you’ve been misusing alcohol, you can get a path to better sleep and overall wellness by getting help. Addiction treatment can help you identify factors that led to your alcohol misuse and teach you how to build positive habits that support a healthy lifestyle.
Medically Reviewed By: Elena Hill, MD, MPH
- Understanding Alcohol Use Disorder. National Institute on Alcohol Abuse and Alcoholism. https://www.niaaa.nih.gov/publications/brochures-and-fact-sheets/understanding-alcohol-use-disorder. April 2021. Accessed December 2022.
- The Different Faces of Insomnia. Frontiers in Psychiatry. https://www.frontiersin.org/articles/10.3389/fpsyt.2021.683943/full. June 2021. Accessed December 2022.
- Insomnia: Prevalence, Impact, Pathogenesis, Differential Diagnosis, and Evaluation. Sleep Medicine Clinics. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2504337/. January 2009. Accessed December 2022.
- How to Interpret the Results of a Sleep Study. Journal of Community Hospital Internal Medicine Perspectives. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4246141/. November 2014. Accessed December 2022.
- An Asymmetrical Hypothesis for the NREM-REM Sleep Alteration — What Is the NREM-REM Cycle? Frontiers in Neuroscience. https://www.frontiersin.org/articles/10.3389/fnins.2021.627193/full. April 2021. Accessed December 2022.
- Short- and Long-Term Health Consequences of Sleep Disruption. Nature and Science of Sleep. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5449130/ May 2017. Accessed December 2022.
- Alcohol’s Effects on Sleep in Alcoholics. Alcohol Research & Health. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2778757/ 2001. Accessed December 2022.
- Insomnia in Alcohol Dependence: Predictors of Symptoms in a Sample of Veterans Referred from Primary Care. American Journal of Addiction. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4393849/ April 2015. Accessed December 2022.
- Alcohol and the Elderly. Clinics in Geriatric Medicine. https://europepmc.org/article/med/1576571 February 1992. Accessed December 2022.
- Connections Between Sleep and Substance Use Disorders. National Institute on Drug Abuse. https://nida.nih.gov/about-nida/noras-blog/2020/03/connections-between-sleep-substance-use-disorders March 2020. Accessed December 2022.
- Pathophysiology of the Effects of Alcohol Abuse on the Endocrine System. Alcohol Research. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5513689/ 2017. Accessed December 2022.
- Evening Alcohol Suppresses Salivary Melatonin in Young Adults. Chronobiology International. https://pubmed.ncbi.nlm.nih.gov/17612945. 2007. Accessed December 2022.
- Identification and Management of Alcohol Withdrawal Syndrome. Drugs. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4978420/. August 2016. Accessed December 2022.
- Tips for Better Sleep. Centers for Disease Control and Prevention. https://www.cdc.gov/sleep/about_sleep/sleep_hygiene.html. September 2022. Accessed December 2022.
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