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Updated on August 31, 2021

Alcohol and Insomnia Connection

What is Insomnia?

There is a link between alcohol and insomnia, referred to as alcohol insomnia. Consumption of alcohol interferes with a person’s ability to enjoy better sleep.

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

Insomnia occurs when a person has sleep difficulties. It might include:

  • Falling asleep
  • Staying asleep
  • Returning to sleep after waking up
  • Awakening after not getting enough hours of sleep
  • Feeling sleepy, lethargic, or fatigued while awake
  • Nightmares

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 use and drug abuse – insomnia can be a side effect of certain drugs and alcohol

Types of Insomnia

The Academy of Sleep Medicine describes insomnia conditions in the following ways:

  • Primary insomnia – occurs without a separate underlying physical or psychological disorder
  • Secondary insomnia – occurs because of another issue, such as a medical condition, psychological disorder, or due to the use of a drug or medication
  • Chronic insomnia – occurs for at least three nights a week for a month or more
  • Acute insomnia – occurs for any duration less than three times a week

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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 abuse and other 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. And in general, the use of alcohol – even healthy use – affects the quality of sleep.

Drinking alcohol does not allow you to get deep sleep. Many people often wake up a few times in the middle of the night without knowing and do not 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)
  • Alcohol also directly affects the circadian rhythms, which is your "biological clock"

Alcohol and Insomnia Statistics

People with alcohol use disorder (alcoholism) experience insomnia at higher rates than those who do not abuse alcohol. Alcohol withdrawal can cause insomnia.

20 percent of adults in the US use alcohol to help them fall asleep.

In 2011, it was estimated that over 252 days are lost across the U.S. Workforce every year due to the symptoms of Insomnia.

It is estimated that 30% to 35% of adults in the U.S. deal with some kind of insomnia.

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

For instance, according to reports published in the Journal of the American Medical Association:

  • Roughly 50 percent of individuals with severe mental disorders are affected by substance abuse
  • 37 percent of alcohol abusers and 53 percent of drug abusers also have at least one serious mental illness
  • Of all people diagnosed as mentally ill, 29 percent abuse either alcohol or drugs.
  • Estimates show that at least 30 percent of individuals diagnosed with major depressive disorder also have co-occurring substance use
  • Approximately half of all people with chronic lower back pain experience insomnia, though it’s unproven whether the pain leads to insomnia or insomnia came before the back pain
  • As many as 28 percent of people with chronic pain use alcohol to alleviate their symptoms

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 observational treatment for alcohol use disorder experienced insomnia during their first six days of withdrawal.

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

  • People with alcoholism, or alcohol use disorder, 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 is using alcohol to cope with the effects of these disorders and he or she stops drinking, the symptoms of the co-occurring disorder tend to heighten.

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Treating Insomnia and Alcohol Addiction

Treatment for alcoholism can be more challenging when the person also has insomnia. The problem worsens when there is an additional co-occurring psychological or physical health condition.

In part, this is because a lack of sleep affects the quality of life and a person’s ability to perform optimally even under the best conditions. The inability to get enough rest during detox and recovery tends to exacerbate the already challenging circumstances, leading to disturbed sleep.

The best option is to take an integrated and comprehensive approach to help a person cope with alcohol use disorder, insomnia, and any co-occurring condition. This means the person receives support and guidance from a multi-disciplinary team of treatment providers.

Alcoholism treatment programs begin with an assessment to evaluate a person’s physical and psychological health and identify all problem areas. Next, he or she undergoes medical detox that allows the patient to manage withdrawal symptoms as effectively as possible.

Medical care related to insomnia and any co-occurring conditions will continue throughout the treatment process. In addition to medications, this might also include different types of therapy that address a person’s use of alcohol, co-occurring issues such as depression or anxiety, and insomnia.

Coping skills aid in falling asleep, such as meditation and breathing techniques, because they improve your mental health. Cognitive-behavioral therapy (CBT) can also help support a healthy sleeping schedule.

Improving Sleep During Alcohol Withdrawal

Some lifestyle changes that can help manage alcohol insomnia include:

  • Altering an existing bedtime routine so it does not 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
  • Utilizing safe, natural sleep aids such as magnesium or melatonin (under a doctor’s supervision)
  • Utilizing 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
  • Refraining from 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 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. Additionally, this can result in excessive daytime sleepiness and other problems the following day.

Drinking to fall asleep can also make you build a tolerance, forcing 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. However, as the effects of alcohol vary from individual to individual, even small amounts of alcohol can worsen sleep quality for some.

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

  • Inpatient Programs — Inpatient treatment is the most intensive and effective option for alcohol addiction treatment. These programs usually last 30, 60, or 90 days, however they may be longer in certain cases. Throughout the duration of an inpatient program you will live on site in a safe, substance-free environment. You will go through medically supervised detoxification first, then behavioral therapy and other services will be added to your regimen. Many of these treatment programs will assist you with an aftercare program afterwards.
  • Partial Hospitalization Programs (PHPs) PHPs are the second most intensive alcohol addiction programs. They are sometimes referred to as intensive outpatient programs (IOPs). Partial hospitalization programs provide comparable services to inpatient programs. These may include detoxification, medical services, behavioral therapy, support groups, and other holistic or custom treatments. The main difference between PHPs and inpatient programs is that in a partial hospitalization program, you return home and sleep at your house. Some PHPs provide food and transportation, but this varies by program. PHPs are ideal for new patients, as well as patients who have completed an inpatient program and still require intensive treatment.
  • Outpatient Programs Outpatient programs are less intensive than inpatient programs and PHPs. They are best for people who are highly motivated to achieve sobriety and have responsibilities at work, home, or school. Outpatient treatment programs customize your treatment sessions around your personal schedule. Outpatient programs can help new patients achieve success. They may also be a part of aftercare programs once a patient completes an inpatient program or PHP.
  • Medication-Assisted Therapy (MAT) Certain patients will qualify for medication-assisted therapy. Some medications can assist you throughout detoxification and withdrawal. Others can reduce cravings and normalize your bodily functions. Disulfiram (Antabuse), acamprosate (Campral), and naltrexone (Revia and Vivitrol) are the most common medications used to treat Alcohol Use Disorder. 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 a first step towards sobriety or a component of an aftercare plan. Many of these programs follow the 12-step approach.

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Resources

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(1) Ornelas, Christopher, and MD. “Chronic Back and Neck Pain’s Close Connection to Insomnia.” SpineUniverse, https://www.spineuniverse.com/wellness/sleep/chronic-back-neck-pain-s-close-connection-insomnia

(2) “Insomnia.” Www.Instituteforchronicpain.Org, https://www.instituteforchronicpain.org/understanding-chronic-pain/complications/insomnia

(3) “Using Alcohol to Relieve Your Pain: What Are the Risks?” National Institute on Alcohol Abuse and Alcoholism (NIAAA), 25 Apr. 2019,https://www.niaaa.nih.gov/publications/brochures-and-fact-sheets/using-alcohol-to-relieve-your-pain

(4) Arnedt, J. Todd, et al. “TREATMENT OPTIONS FOR SLEEP DISTURBANCES DURING ALCOHOL RECOVERY.” Journal of Addictive Diseases, vol. 26, no. 4, 2007, pp. 41–54, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2936493/

(5) Pietilä, Julia et al. “Acute Effect of Alcohol Intake on Cardiovascular Autonomic Regulation During the First Hours of Sleep in a Large Real-World Sample of Finnish Employees: Observational Study.” JMIR mental health vol. 5,1 e23. 16 Mar. 2018, https://pubmed.ncbi.nlm.nih.gov/29549064/ (6) Colrain, Ian M et al. “Alcohol and the sleeping brain.” Handbook of clinical neurology vol. 125 (2014): 415-31, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5821259/ 

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