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Why I Can’t Get No Sleep with Alcohol and Drugs

Man awake at 5.30am with insomnia in business suit on bed

A good night’s sleep: most of us feel the difference when we’ve slept really well. But for many people, sleep is an elusive dream. On average, adults need 7 to 9 hours of sleep per day. One third of British people have episodes of insomnia. Amongst the most common causes of insomnia, the NHS list alcohol, caffeine, nicotine, recreational drugs including cocaine and ecstasy, as well as stress, anxiety and depression.

This World Sleep Day, here are four compelling studies that have measured the impacts of alcohol and/or drug use on sleep. If you’re addicted and you want help to stop, get in touch with us here about addiction treatment at Help Me Stop.

Alcohol and sleep quality

This study from 2018 measured the impact of low, moderate and high alcohol intake on sleep quality. Researchers found that even low amounts of alcohol affected sleep quality, with the effects on sleep increasing further with greater quantities of alcohol.

  • LOW alcohol intake reduced sleep quality by 9.3%:
    • <2 alcohol servings each day for men; <1 alcohol serving per day for women
  • MODERATE alcohol intake reduced sleep quality by 24%
    • 2 alcohol servings each day for men; 1 alcohol serving per day for women
  • HIGH alcohol intake reduced sleep quality by 39.2%
    • >2 alcohol servings each day for men; >1 alcohol serving per day for women

Cocaine and sleep quality

This comprehensive review from 2016 into sleep abnormalities and alcohol/ drug use found many correlations between cocaine use and impaired sleep. This includes in the period of active cocaine use, as well as in cocaine withdrawal. Over time, researchers found sleep improvements amongst those who quit cocaine.

  • ‘Chronic cocaine users appear to have dramatically diminished slow-wave sleep time relative to age-matched healthy sleepers.’ 
  • ‘Cocaine administration acutely suppresses REM sleep.’
  • ‘The first several days to 1 week after cocaine cessation are characterized by sleep disturbances, hypersomnia, bad dreams, depressed mood, psychomotor agitation and retardation, fatigue, and increased appetite.’
  • ‘With continued abstinence, however, there is subjective improvement of sleep as well as improvements in other cocaine withdrawal measures, with apparent normalization of subjective sleep over the course of several weeks.’
  • ‘Numerous studies have indicated an improvement in self-reported sleep quality over the first few weeks of abstinence, with improvements in measures such as overall sleep quality, daytime alertness, concentration/confusion, depth of sleep, and energy/fatigue.’
  • ‘There is evidence that chronic cocaine users have chronically impaired sleep as measured by instruments like the PSQI. Self-reported sleep quality improves with continued abstinence. Self-reported sleep quality after an extended period of abstinence is similar to that in healthy sleepers.’

Opioids and sleep quality

This 2019 position statement from the American Academy of Sleep Medicine on chronic opioid therapy describes the complex relationship between opioids, sleep and daytime function. They acknowledge that fatigue and disturbed sleep are common symptoms of chronic pain, which is often the reason people seek out medical advice that results in opioid prescribing. But they also make clear that long term opioids can exacerbate sleep problems.

  • ‘Chronic opioid therapy can alter sleep architecture and sleep quality as well as contribute to daytime sleepiness.’
  • ‘Opioids are associated with several types of sleep-disordered breathing, including sleep-related hypoventilation, central sleep apnea (CSA), and obstructive sleep apnea (OSA).’
  • ‘Regular, chronic use of opioids is known to interfere with sleep via several mechanisms. It can lead to changes in sleep architecture including a reduction in sleep efficiency as well as slow wave sleep.’
  • ‘Chronic opioid therapy requires careful clinical attention because of the serious risks of addiction, abuse, and overdose.’

Cannabis and sleep quality

This US study found a correlation between cannabis use and extremes of sleep duration (less than 6 hours or more than 9 hours of sleep per night).

  • ‘A total of 3132 (14.5%) respondents said they had used cannabis in the preceding 30 days. Recent users were more likely to report not sleeping enough or sleeping too much.’
    • ‘They were 34% more likely to report short sleep and 56% more likely to report long sleep than those who hadn’t used cannabis in the preceding 30 days.’
    • ‘They were also 31% more likely to report difficulty falling asleep, staying asleep, or sleeping too much in the preceding 2 weeks.’
    • ‘They were 29% more likely to have discussed a sleeping problem with a doctor.’
  • ‘Heavy users, defined as using on 20 or more out of the preceding 30 days, were 64% more likely to experience short sleep and 76% more likely to experience long sleep compared with non-users.’

Help Me Stop provide affordable Dayhab treatment for addiction, face-to-face and online. Call 0208 191 9191 or contact us here to talk in confidence.

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