Sleep Problems Associated With Alcohol Misuse

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. In fact, difficulty sleeping is one of the most common alcohol withdrawal symptoms and one that causes many to relapse.

This article discusses how alcohol affects sleep and the disruptions you might continue to experience after you quit drinking. It also explores why you might feel like you can't sleep sober and what you can do to cope.

Types of Alcohol-Related Sleep Problems

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

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

Such effects lead people to feel that they did not get enough sleep. Daytime sleepiness, reduced concentration, irritability, and other symptoms can then result.

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

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.

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.

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.

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.

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 have been shown to be 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:

• Aromatherapy
• Mindfulness meditation
• Relaxation and biofeedback therapy
• Progressive muscle relaxation
• Yoga
  

Coping With Alcohol-Related Sleep Problems

Working on your sleep hygiene is another way to help prevent or reduce insomnia. These are 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 prior to lights out will help set the tone for solid slumber.
• Keep your room dark, cool, and comfortable. Avoid the use of 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 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. According to a study published in Psychology, Health & Medicine, the average person loses more than one minute of sleep for every cigarette they smoke.

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A Word From Verywell

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.