Sleep Difficulties Associated with Alcohol Abuse

Many people who struggle with alcohol use disorders also experience sleep problems. Even occasional excessive drinking can disrupt sleep.

These issues may persist for some time even after deciding to quit drinking. In fact, difficulty sleeping is one of the most common symptoms of alcohol withdrawal, often leading to relapse.

This article examines how alcohol affects sleep and the disturbances you may encounter after quitting. It also delves into why you might feel like you can't sleep sober and offers coping mechanisms.

If you or a loved one are battling substance use or addiction, contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-4357 for information on support and treatment facilities in your area. For more mental health resources, visit our National Helpline Database.

Types of Alcohol-Related Sleep Issues

According to the Substance Abuse and Mental Health Services Administration (SAMHSA), 25% to 72% of individuals with alcohol use disorders report sleep disturbances. The most prevalent and disruptive effects include:

• Increased awakenings
• Compromised sleep quality
• Reduced deep sleep
• Earlier-than-usual waking times

These effects result in feelings of insufficient sleep. Daytime drowsiness, impaired concentration, irritability, and other symptoms may follow.

Studies have shown that sleep problems can persist for weeks, months, or even years after quitting drinking. Often, people recovering from alcohol use experience more difficulty with sleep onset than with sleep maintenance.

Many individuals in recovery from alcohol use disorders had sleep problems before their alcohol dependence.

Unfortunately, recovery and abstinence become more challenging without sufficient quality sleep. Difficulty sleeping, especially when accompanied by the belief that you can't sleep sober, may increase the risk of relapse.

Non-Restorative Sleep

Individuals in alcohol recovery often experience long sleep onset latencies, difficulty sleeping through the night, and non-restorative sleep.

Alcohol withdrawal leads to decreased deep sleep and abnormalities in REM sleep. REM sleep is characterized by heightened brain activity, muscle relaxation, rapid eye movements, and increased dreaming.

Sleep problems are often viewed as one of the last symptoms to improve among individuals in alcohol recovery. This symptom also poses a significant relapse risk.

In fact, 12-step recovery programs often refer to the factors that elevate a person's relapse risk as HALT, standing for Hungry, Angry, Lonely, or Tired. Sleep disruptions may heighten the risk of feeling tired, potentially leading to relapse if the individual believes they can't sleep sober.

Insomnia

Insomnia is prevalent among adults, but it is not uncommon to experience it both in the short-term and long-term after quitting drinking. Insomnia is characterized by difficulty falling or staying asleep, resulting in daytime drowsiness, concentration problems, and other adverse health effects.

People in recovery are often more likely to have problems with sleep onset than with sleep maintenance, which is why some might conclude that they can't sleep sober.

Types of Insomnia

• Onset insomnia: Difficulty falling asleep
• Maintenance insomnia: Inability to sleep through the night (waking up and not being able to fall back to sleep)
• Acute insomnia: Brief period of trouble sleeping, often caused by a stressful life event or experience
• Chronic insomnia: Problems falling or staying sleeping for at least three nights per week for three months or longer
• Comorbid insomnia: Occurs with another condition, like depression or anxiety, that also interferes with sleep

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 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 primary 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 have been proven effective and will not interfere with sobriety.

• Cognitive Behavioral Therapy for Insomnia (CBT-I)

The goal of cognitive behavioral therapy for insomnia (CBT-I) is to modify sleep habits and address misconceptions about sleep and insomnia that may perpetuate sleep difficulties.

CBT-I typically involves regular, weekly meetings, during which your therapist will conduct sleep assessments, collaborate with you to change problematic sleep behaviors, and ask you to complete a sleep diary at home.

• Sleep Restriction

This behavioral therapy aims 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 strengthen your desire to sleep (called sleep drive) and sleep less fitfully and more efficiently.

• Medication

There are numerous 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:

• Acupuncture
• Massage therapy
• Yoga
• Tai chi
• Meditation

Coping With Alcohol-Related Sleep Problems

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

• Develop a relaxing bedtime routine. Whether it's journaling, using a meditation app, or unwinding with a warm bath, engaging in calming activities before lights out helps set the tone for sound slumber.

• Keep your room dark, cool, and comfortable. Avoid using television, 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 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.

• Maintain a regular sleep/wake schedule. This helps your body adjust to a specific bedtime, making it easier to fall asleep at that time.

• Avoid napping. Naps reduce your overall sleep debt, making it harder to fall asleep again at night at the appropriate time.

• Refrain from stimulants in the evening. Stimulants that disrupt sleep include caffeine (coffee, tea, soft drinks, chocolate) and nicotine. According to a study published in Psychology, Health & Medicine, the average person loses more than one minute of sleep for every cigarette they smoke.

A Word From Verywell

Alcohol can adversely affect sleep, and these difficulties can persist after you decide to stop drinking. Finding ways to manage insomnia and other sleep issues is essential since poor sleep can contribute to alcohol relapse.

Fortunately, treatments and coping techniques can help you achieve better rest, leading to improved well-being during alcohol recovery. If you are experiencing sleep problems, be sure to discuss your options with your doctor.