Alcohol and Insomnia Connection

What is Insomnia?

There's a link between alcohol and insomnia, referred to as alcohol insomnia. The substance interferes with the ability to sleep well.

It's common for someone who's alcohol-dependent to experience long-term sleep problems. Insomnia and other sleep disorders are typical symptoms of alcoholism.

Insomnia occurs when a person has sleep difficulties such as falling or staying asleep.

Risk factors that increase a person’s potential for developing insomnia include:

• Age: Older people develop insomnia more than younger people
• Gender: Women are more prone to insomnia than men
• Health: Some physical and psychological medical conditions trigger insomnia
• Alcohol and drug abuse: Insomnia can be a side effect of certain drugs and alcohol

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Alcohol Insomnia Connection

Alcohol and insomnia have a “bidirectional” relationship. This means people with insomnia tend to have an increased risk of alcohol and substance use disorders.

Insomnia doesn’t directly cause alcoholism, nor does alcoholism always cause insomnia. The relationship between the two disorders is complicated and closely linked.

Generally, even healthy alcohol use affects sleep quality.

Drinking alcohol doesn't allow you to get enough deep sleep. Many people often wake up a few times in the middle of the night without knowing and can't enjoy a normal sleep routine.

Effects of Alcohol on Sleep

Drinking alcohol can lead to the following sleep problems:

• Increases the time needed to fall asleep
• Disrupts total sleep time
• Decreases sleep quality
• Increases a person’s likelihood to snore or experience sleep apnea
• Causes daytime sleepiness the following day
• Interferes with REM sleep (rapid eye movement sleep)
• Affects the circadian rhythms, your "biological clock"
• Nightmares

Alcohol Withdrawal and Insomnia

Someone with alcohol use disorder has a high risk of developing insomnia as part of the withdrawal and recovery process.

In one study, 58 percent of men in treatment for alcohol use disorder experienced insomnia during their first few days of withdrawal.⁴

There are a few reasons why alcohol withdrawal and insomnia are linked, including:

• People with alcoholism experience sleep problems before or early on in their addiction
• People with alcoholism tend to drink alcohol to help them sleep. An alcoholic drink might even be part of their bedtime routine
• Alcoholism might co-occur with other medical conditions such as anxiety or depression. Both of which have insomnia as a symptom
• When a person uses alcohol to cope with the effects of these disorders, and they stop drinking, the symptoms of the co-occurring disorder tend to heighten

Insomnia can continue for weeks, months, or even years. It can lead to increased:

• Anxiety
• Tiredness
• Low enthusiasm
• Irritability
• Poor concentration

If left untreated, insomnia can affect a person's recovery and contribute to relapse.

Fortunately, insomnia typically goes away over time. However, there are many coping skills a person can practice to improve their sleep.

Tips For Improving Sleep During Alcohol Withdrawal

Some lifestyle changes that can help manage alcohol insomnia include:

• Changing an existing bedtime routine so it doesn't include alcohol consumption
• Maintaining a consistent sleeping and waking time
• Unwinding with relaxing activities (that don’t involve drinking alcohol) before bedtime
• Avoiding stressful situations, especially within a few hours of bedtime
• Using safe, natural sleep aids like magnesium or melatonin under a doctor’s supervision
• Using over-the-counter or prescription sleep aids under a doctor’s supervision
• Exercising daily or several times a week at least four to six hours before bedtime
• Creating a cool, comfortable sleeping environment
• Avoiding naps
• Avoiding using computers, cell phones, and e-readers
• Creating other healthy sleep habits

Alcohol dependency is rarely the only issue a person in withdrawal is dealing with. This is why a comprehensive approach to treatment is often the key to a successful recovery.

Alcohol and Insomnia Statistics

People with alcohol use disorder experience insomnia at higher rates than those who don't abuse alcohol. For example:

• Approximately 20 percent of adults in the U.S. use alcohol to help them fall asleep.⁷
• In 2011, an estimated 252 days are lost across the U.S. workforce every year due to insomnia. ⁸
• An estimated 30 to 35 percent of adults in the U.S. deal with insomnia. ⁹

Additionally, people with co-occurring medical conditions have an even higher risk of developing insomnia and/or alcohol use disorder.

According to reports:

• Roughly 50 percent of people with severe mental disorders are affected by substance abuse.
• Around 37 percent of alcohol abusers and 53 percent of drug abusers have at least one serious mental illness.
• Of those diagnosed as mentally ill, 29 percent abuse alcohol or drugs.
• At least 30 percent of people diagnosed with major depressive disorder also have co-occurring substance use.
• Approximately half of all people with chronic lower back pain experience insomnia. It’s unproven whether the pain leads to insomnia or the other way round.
• Up to 28 percent of people with chronic pain use alcohol to treat their symptoms.

Alcohol and Insomnia FAQs

Here are some frequently asked questions about alcohol and insomnia:

Does Alcohol Help You Sleep?

Alcohol may help with sleep onset because of its sedative properties, allowing you to fall asleep more quickly.

However, people who drink alcohol before bed often experience disruptions later in their sleep cycles when liver enzymes metabolize alcohol. This can result in excessive daytime sleepiness and other problems the following day.

Drinking to fall asleep can also make you build a tolerance. This forces you to drink more alcohol each night to experience the sedative effects.

Will a Small Amount of Alcohol Disturb My Sleep?

Consuming alcohol in excess is likely to have a more negative impact on sleep than light or moderate alcohol consumption. And since the effects of alcohol vary, even small amounts can worsen sleep quality in some people.

One study compared sleep quality among people who consumed different amounts of alcohol.⁵ The results are as follows:

• Low amounts of alcohol (less than two servings per day for men or one per day for women) reduced sleep quality by 9.3 percent.
• Moderate amounts of alcohol (two servings per day for men or one serving per day for women) lessened sleep quality by 24 percent.
• High amounts of alcohol (more than two servings per day for men or one serving per day for women) reduced sleep quality by 39.2 percent.

Treatment Options for Alcohol Abuse & Addiction

Here are some of the best treatments for AUD:

Inpatient Programs

Inpatient treatment is the most intensive and effective option for alcohol addiction treatment. These programs usually last 30, 60, or 90 days. They may be longer in some cases.

Throughout an inpatient program, you'll live on-site in a safe, substance-free environment. You'll go through medically supervised detox first, then behavioral therapy. Other services may be added to your regimen.

Many of these treatment programs assist you with an aftercare program afterward.

Partial Hospitalization Programs (PHPs)

PHPs are the second most intensive alcohol addiction programs. They're sometimes called intensive outpatient programs (IOPs). PHPs provide comparable services to inpatient programs.

These services may include:

• Detox
• Medical services
• Behavioral therapy
• Support groups
• Other holistic or custom treatments

The main difference between PHPs and inpatient programs is that you return home and sleep at your house during a partial hospitalization program.

Some PHPs provide food and transportation. This varies by program.

PHPs are ideal for new patients and those who have completed an inpatient program and still require intensive treatment.

Outpatient Programs

Outpatient programs are less intensive than inpatient programs and PHPs. They're best for people who are highly motivated to achieve sobriety. Patients usually have responsibilities at work, home, or school.

These programs customize your treatment sessions around your schedule.

Outpatient programs may be part of aftercare once a patient completes an inpatient program or PHP.

Medication-Assisted Therapy (MAT)

Certain people qualify for medication-assisted therapy. Some medications can assist you throughout detox and withdrawal. Others can reduce cravings and normalize your bodily functions.

The most common medications used to treat AUD are:

• Disulfiram (Antabuse)
• Acamprosate (Campral)
• Naltrexone (Revia and Vivitrol)

MAT can help prevent relapse and increase your chance of recovery if combined with other therapies.

Support Groups

Support groups are peer-led organizations made of people dedicated to helping each other stay sober. They can be the first step towards sobriety or part of an aftercare plan.

Many of these programs follow the 12-step approach.

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