The Link Between Alcohol & Insomnia

Regardless of a person’s level of alcohol use, it’s common to associate insomnia or sleep disruption with a drink.

Firstly, in the sense that people might turn to drink as a sleep aid and secondly due to the effects alcohol has on sleep during the night.

In the UK, around 16 million adults suffer from insomnia. [1] There’s a definite link between poor quality of sleep and increased alcohol use.

What many don’t realise is that any level of alcohol consumption can affect sleep in a negative way, despite initial assumptions about its effects.

As well as impaired sleep, regular alcohol use in an attempt to self-medicate around insomnia comes with a variety of risks, not least of which is addiction.

What Happens When You Drink

It’s helpful to know a little about what alcohol does when you drink. Firstly, it enters the stomach and small intestine and is absorbed into the bloodstream.

There are enzymes in the liver that metabolise alcohol but because this process is slow, alcohol actually stays in the body for quite a while.

The way it affects the individual and the duration of time it remains in the system varies according to age, sex, and body type.

Another effect of alcohol is that it stimulates gamma-aminobutyric acid (GABA), which is an inhibitory neurotransmitter that makes people feel relaxed and sleepy. This is the reason people might turn to drinking as a sleep aid.

What’s Insomnia?

The NHS describes insomnia as when a person regularly has problems sleeping. It varies from person to person but the main symptoms include:

• Struggling to fall asleep
• Not reaching deep sleep
• Waking up throughout the night
• Not sleeping for many hours

Long-term or chronic insomnia is where these symptoms persist for longer than three months. It can be caused by both internal and external triggers, including:

• Stress (i.e. work responsibilities)
• Upsetting event (i.e. bereavement)
• Eating too much late in the day
• Drinking too much caffeine
• A mental health condition (i.e. anxiety, or bipolar disorder)
• A deregulated circadian rhythm (the body’s internal clock linked to sleep and wakefulness which usually corresponds to night and day)

Risks related to insomnia

Long-lasting insomnia comes with a variety of risks which can severely impact life. When people live with the symptoms outlined below, symptoms of insomnia and related conditions can go on to exacerbate each other making for a poor quality of life.

Insomnia can cause and is linked to:

• Impaired cognitive and social functioning
• Impaired memory
• Mental disorders, such as depression
• Risks when driving or operating machinery
• Physical health problems such as heart disease and risk of heart attack, diabetes, and obesity

How Alcohol Affects Sleep

Truthfully speaking, the reason people turn to alcohol to support sleep is because of its sedative effects. While alcohol has initial sedative effects, the way its processed has other effects that people are often unaware of.

There are many studies that show how heavy drinking and alcohol abuse causes late sleep onset and a poor quality of sleep. As well as this, alcohol is actually linked to increasing the chances of and worsening the symptoms of a variety of sleep disorders.

When alcohol is drunk late in the day, it’s metabolised during the night. This as well as the drop in alcohol and sugar levels causes disrupted sleep.

Sleep Cycles and the Impact of Alcohol

To understand more about how alcohol causes impaired sleep, it’s useful to know a bit about sleep, its stages, and sleep cycles.

To start with, there are 4 different stages of sleep: 3 non-rapid eye movement (NREM) stages and 1 rapid eye movement stage (REM). Running (or sleeping!) through every one of these four stages takes between 1.5 – 2 hours; this counts as one cycle.

In a healthy full night’s sleep, people repeat this cycle going through it four or five times.

1. The first stage of sleep is the NREM where you move from being awake to going to sleep. The body slows down (the muscles, brain, activity, heartbeat, breathing, and eye movement).
2. The second NREM stage is where you move from light towards deeper sleep. Body temperature decreases and eyes become still. This stage is the longest part of the cycle.
3. The third and final NREM stage is slow-wave sleep where brain activity, heartbeat, and breathing are at their slowest. Muscles and eye movements are totally still.
4. The final of the four stages is the REM stage where eye movements start up again and breathing and heart rate pick up. This is the stage where dreams tend to occur and is associated with memory and learning.

In the first cycle, the REM stage lasts around ten minutes and by the final cycle it can last around forty minutes and the other stages reduce their duration to accommodate this.

Alcohol use suppresses the REM stage, sleep onset can come on quicker and deep sleep can come too soon. The balance between the stages is upset leading to poor sleep quality, reduced sleep time, and sleep disruption.

Due to how alcohol affects the stages of sleep, the second half of a night’s sleep means insomnia is more likely to occur and you’re therefore more likely to experience sleepiness during the day.

Of course, this often means that people then use stimulants (i.e. caffeine) to stay awake and focus during the day and then, of course, by night people seek out sedatives again. It becomes a vicious cycle.

As well as this alcohol use can disrupt sleep due to its effects on body temperature regulation, dehydration and associated headaches, as well as increased bathroom visits.

Binge-drinking and Sleep

It’s well known that consuming high amounts of alcohol in a short space of time means that disturbed sleep is almost guaranteed. This can also be seen in the few nights following a binge-drinking session.

It’s equally as hard for men and women to fall and stay asleep as it is for people of all ages.

Alcohol Use and Sleep Apnea

Sleep apnea is when during sleep people breathe in a disrupted way. Sometimes people might even stop breathing temporarily.

This is linked to blockages in the back of the throat (obstructive sleep apnea) or can be linked to the brain being unable to send appropriate messages to regulate breathing properly (central sleep apnea).

Alcohol use severely exacerbates sleep apnea because it relaxes the throat more than usual and causes more obstructions in the throat. This also causes people to snore.

The Link Between Alcohol Use Disorder & Insomnia

Insomnia symptoms increase the abuse potential of alcohol. When people turn to alcohol to manage sleep they can become reliant on it in two ways:

1. As a method to help them sleep (i.e. stop trying other things that promote healthy sleep).
2. Because it’s an addictive substance.

When substance abuse such as alcohol use disorder exists alongside a mental health condition such as insomnia, this is referred to by professionals as a “dual diagnosis”. This isn’t uncommon in the field of addiction because people often turn to substances to manage mental health symptoms.

Interestingly, substances, including alcohol, can obviously cause mental health conditions too because of their effects on brain chemistry and hormones. Therefore, it’s often difficult to identify which came first; the mental health issue or the addiction.

Research shows that “men who drink more over three decades” and who have “hazardous” drinking are likely to have worse sleep habits, are more likely to wake up tired, and to also wake up often. [2] As well as this, insomnia is associated with more alcohol cravings. [3]

When people use alcohol to try and get to sleep (known as self-medicating), they can become addicted or even alcohol dependent. When this happens, withdrawal symptoms begin.

This makes it much harder to stop using alcohol in general, not simply in relation to sleep.

Alcohol Withdrawal and Insomnia

Where alcohol addiction or dependency has developed it’s incredibly likely that people will experience insomnia during withdrawal. [4] This is a common symptom regardless of whether insomnia existed before alcohol use.

Sleep disruption can actually be quite challenging during the early stages of recovery. It’s therefore really helpful to seek professional guidance for tips on how to manage this.

If you’re alcohol dependent, you’ll need an alcohol detox to wean you off the substance safely as it can be dangerous to attempt alone at home.

Where sleep problems exist long-term beyond detox and abstinence, it’s important to seek medical help for the treatment of insomnia.

Treatment For Alcohol Use Disorder & Insomnia

If you have developed an alcohol use disorder alongside insomnia, you can enter a rehab clinic. Doing so offers the best way to become sober for alcohol-dependent patients and supports a person to find a routine that develops sleep efficiency so more hours of sleep are achieved.

At a private clinic, you’ll begin a treatment programme with the 7-10 day detox. Residents are usually given a Librium prescription in order to manage symptoms of withdrawal so that they wean off alcohol safely.

After this, treatments move to psychological, social, and holistic approaches. This is where skills are developed to identify triggers and manage cravings. As well as this, you explore ideas and make decisions on how to create a new lifestyle without alcohol.

One of the main therapies used to address both alcohol addiction and persistent insomnia is cognitive behavioural therapy. This will make up a solid part of your treatment plan.

It teaches you how to retrain your thought patterns to develop healthy new behaviours.

As well as this, other treatments include dialectical behavioural therapy, motivational interviewing, counselling, mindfulness, meditation, 12 Step groups, SMART recovery sessions, art therapy, music therapy, equine therapy, yoga, reiki, and ear acupuncture.

Final Thoughts

Research shows there’s a clear relationship between alcohol use and insomnia. Despite the fact people often use alcohol to try and improve their lack of sleep; it actually results in reduced sleep and disturbed sleep.

There are many negative physical and psychological effects of insomnia and this coupled with alcohol use can create a cycle where people keep using alcohol. In fact, when people use alcohol regularly during sleep, it can lead to addiction and even dependency where people become chronic alcohol users.

Whether alcohol use is moderate or severe, people can access excellent treatment at private rehab clinics to receive treatment for both alcohol use and insomnia.

To find out where you can get support for alcohol and insomnia, contact Rehab 4 Alcoholism at 0800 111 4108. One of our team members will be happy to explain your options.

FAQs

Is alcohol a cause of insomnia?

Alcohol use, at any level, increases the risk of insomnia. This is because it delays the onset of sleep, sleep quality, and duration of sleep.

Why is it hard to sleep when you drink alcohol?

The reason it’s hard to sleep when you drink alcohol is that alcohol is metabolised in the body. This affects body temperature regulation and sugar levels.

Alcohol also disrupts NREM and REM sleep stages in the sleep cycle making disrupted sleep more likely.

How long does insomnia last after you stop drinking alcohol?

When you stop drinking alcohol, insomnia can go on for days, weeks, and even the first couple of months. It’s important to seek medical advice around this where insomnia persists.

What are some alternatives to alcohol for insomnia?

The healthiest way of managing insomnia is by creating a bedtime routine that helps you relax and unwind. This might include reading, guided meditations, and a set bath time.

Herbal remedies (such as valerian) and pharmaceutical options can be explored under professional guidance.

References

[1] https://www.aviva.com/newsroom/news-releases/2017/10/Sleepless-cities-revealed-as-one-in-three-adults-suffer-from-insomnia/

[2] https://www.nature.com/articles/s41598-020-62227-0

[3] https://pubmed.ncbi.nlm.nih.gov/31087085/

[4] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2936493/