Disturbed Sleep and Its Relationship to Alcohol Use - Dimensions
The gut and its microbiome are often referred to as the body's second brain, and The circadian disruption that can result from alcohol consumption contributes to There's a complicated relationship among depression, alcohol and sleep. It also leads to lighter, more restless sleep as the night wears on. Insomnia or sleep disturbance is widely prevalent in alcohol dependence. PD () Disturbed sleep and its relationship to alcohol use. Alcohol consumption at almost any level can cause sleep sleep-inducing effects decrease, while its sleep disturbance effects increase.
No studies have demonstrated the hypnotic efficacy of benzodiazepines beyond 12 weeks. For these reasons, benzodiazepines should probably be considered only after alternative therapies have proven ineffective These cautions probably apply to the nonbenzodiazepines as well, although studies of their chronic use and abuse in recovering alcoholic populations are limited.
Pharmacological alternatives commonly prescribed for sleep disorders in alcohol-dependent patients include sedating antidepressants, antihistamines, and low-potency neuroleptics, but these agents have not been rigorously studied as sleep agents Trazodone, a sedating antidepressant, is the medication most commonly prescribed by addiction experts for insomnia among sleep-disturbed alcoholics We are performing an ongoing clinical trial to examine its effect on sleep and alcohol outcomes in early recovery.
Ritanserin, a specific 5-hydroxytryptamine antagonist was tested at three doses against placebo over 6 months in a randomized trial with detoxified alcohol-dependent individuals None of the three dosages revealed significant improvement over placebo in sleep quality in persons without psychiatric disorders. During the first two weeks after detoxification, five days of carbamazapine was superior to lorazepam in improving sleep for patients with mild to moderate alcohol withdrawal Gabapentin, an anticonvulsant, in an open label, uncontrolled study, also showed promise as a safe and effective treatment for alcohol-dependent patients with insomnia during early recovery However, scientific consensus maintains that chronic use ultimately disrupts sleep-related physiology—even among those who do not meet diagnostic criteria for alcohol dependence.
Better prospective clinical and laboratory sleep studies of alcohol use and insomnia are clearly warranted. Fine-grained longitudinal assessments of the relationship between the level of alcohol consumption and sleep problems on a night-to-night basis are also needed to inform medical practitioners about the proper advice e. The views expressed in this article are those of the authors and do not necessarily represent the views of the National Institute on Alcohol Abuse and Alcoholism, National Institute on Drug Abuse, or Department of Veterans Affairs.
Footnotes Full terms and conditions of use: The accuracy of any instructions, formulae and drug doses should be independently verified with primary sources.
The truth about alcohol and sleep
The publisher shall not be liable for any loss, actions, claims, proceedings, demand or costs or damages whatsoever or howsoever caused arising directly or indirectly in connection with or arising out of the use of this material. Clinical correlates of insomnia in patients with chronic illness.
Sleep problems and their correlates in a working population. J Gen Int Med. Wiley J, Camacho T. Life-style and future health: Evidence from the Alameda County Study. Risk factors associated with complaints of insomnia in a general adult population.
Epidemiologic study of sleep disturbances and psychiatric disorders. Alcohol and the elderly. Schuckit MA, Irwin M. Med Clin N Am. A review of the effects of moderate alcohol intake on the treatment of anxiety and mood disorders.
The use of polysomnography in the evaluation of insomnia. Ethanol as a hypnotic in insomniacs: Self administration and effects on sleep and mood. Effect on inferred visual dreaming. Effect of alcohol on sleep and nighttime plasma growth hormone and cortisol concentrations. J Clin Endoc Metab. The biphasic effects of ethanol on sleep latency. Sleep extension, enhanced alertness and the sedating effects of ethanol. Maclean AW, Cairns J. Dose-response effects of ethanol on the sleep of young men.
Late-afternoon ethanol intake affects nocturnal sleep and the sleep EEG in middle-aged men. Residual sedating effects of ethanol. Alc Clin Exp Res. Alcohol and sleep in young adults. Ancoli-Israel S, Roth T. Characteristics of insomnia in the United States: Results of the National Sleep Foundation Survey. Epidemiology of alcohol and medication as aids to sleep in early adulthood.
An overview of insomnias and related disorders—recognition, epidemiology, and rational management. Sedative effects of ethanol at night. How sleep and mental disorders are related to complaints of daytime sleepiness. Automobile accidents in patients with sleep disorders.
Insomnia, alcohol, and over-the-counter drug use in old-old urban women. J Comm Health Nursing. The psychological benefits of moderate alcohol consumption: A review of the literature. Prevalence of sleep disorders in the Los Angeles Metropolitan Area.
Self-report versus sleep laboratory findings in drug-free subjects with complaints of chronic insomnia. Baekeland F, Hoy P. Insomnia in men—A 10 year prospective population based study.
Disturbed sleep and its relationship to alcohol use.
A study of the impact of occupational and domestic factors on insomnia among industrial workers of a manufacturing company in Japan. Combined effects of shift work and lifestyle on the prevalence of insomnia, sleep deprivation and daytime sleepiness. Scand J Work Environ Health.
Correlates of sleep problems among men: The Vietnam Era Twins Registry. Clinical correlates of reported sleep disturbance in alcoholics. Q J Stud Alcohol. The acute alcohol withdrawal syndrome: Prevalence, trends, and incidence of alcohol withdrawal symptoms: Analysis of general population and clinical samples.
Alc Health Res World. Predictors of relapse to heavy drinking in alcohol dependent subjects following alcohol detoxification—The role of quality of life measures, ethnicity, social class, cigarettes and drug use. Behavioral studies of sleep patterns in alcoholics during intoxication and withdrawal. Alcohol has a direct effect on circadian rhythms, diminishing the ability of the master biological clock to respond to the light cues that keep it in sync.
Those effects of alcohol on the biological clock appear to persist even without additional drinking, according to research. Circadian rhythms affect how the body responds to alcohol, depending on the timing of alcohol intake. Long-established research shows the body metabolizes alcohol differently at different times of day. Studies have shown the body is more effective at processing alcohol at certain times of the day than others.
The most effective time of day for the body to metabolize alcohol, according to research?
Early to middle evening hours. The time of day when the body is least well prepared? If that mimosa with brunch hits you particularly hard, it may be the result of circadian timing.
The more you drink, and the closer your drinking is to bedtime, the more it will negatively impact your sleep. Even moderate amounts of alcohol in your system at bedtime alters sleep architecture —the natural flow of sleep through different stages. It also leads to lighter, more restless sleep as the night wears on, diminished sleep quality, and next-day fatigue.
What does drinking alcohol do to a night of sleep? Alcohol often does reduce sleep onset latency—the time it takes to fall asleep. Depending on how much alcohol is consumed, however, what seems like falling asleep may be something closer to passing out. And we quickly build a tolerance for the sedative effects of alcohol, which means you may need to drink more to have the same initial sleep-inducing effects.
For many people who drink moderately, falling asleep more quickly may seem like an advantage of a nightly glass of wine. But alcohol goes on to affect the entire night of sleep to come.
In the first half of the night, when the body is metabolizing alcohol, studies show people spend more time in deep, slow-wave sleep and less time in REM sleep. It may sound like a good idea to spend more time in deep sleep. REM sleep, which gets shortchanged in the first half of the night under the influence of alcohol, is important for mental restoration, including memory and emotional processing. During the second half of the night, sleep becomes more actively disrupted.
During the second half of the night, sleep architecture shifts again away from normal, with less time spent in slow wave sleep. The rebound effect may include more time in REM—a lighter sleep stage from which it is easy to be awakened.