The Relationship Between Sleep And Substance Abuse

The importance of sleep as related to substance abuse (or other mental health disorders) can’t be understated.

Drug and alcohol abuse contributes to poor sleep patterns while using substances. This disturbance can lead to insomnia while in recovery, contributing to an increased risk of relapse.

Why Sleep Is Important

Sleep affects every aspect of our health. When we get enough sleep our overall health improves. But when our sleep patterns are disrupted, especially for long periods of time, our overall health declines.

Some of the areas affected by sleep include:

the immune system
brain development in children and adolescents
the formation of long-term memories
the circulatory system
the respiratory system
hormones that are only made during the sleep cycle
the ability to think

There have even been calls to change some areas in public policy because of the negative effects on sleep. For example, daylight saving time and fallback are both associated with higher incidences of cardiac problems and car accidents.

Some school districts have later start times for school because studies have shown that this allows teens to perform better in school.

Stages Of Sleep

When you fall asleep, your body enters a different state of consciousness, one in which you are unaware of what is going on around you. But your brain is very active during sleep, and this activity changes throughout the course of a healthy sleep cycle.

Throughout the course of a healthy night’s sleep, your body should cycle through the stages of sleep four or five times. Each sleep cycle has four stages.

Stage One

The first stage of sleep is when you are awake. This can include wakefulness prior to falling asleep and when you are waking up.

It also includes periods of wakefulness throughout the night. As your body cycles through the sleep stages, you wake up periodically, which is normal. Many times you don’t remember these periods.

Stage Two

During stage two, you enter a period of light sleep. This period is when your heart rate and body temperature drop.

It is during this time that your body relaxes and sometimes your muscles jerk. It is easy to wake up during this stage of sleep.

This stage is the non-REM stage of sleep, or N-REM. it is important to your creativity and the formation of memories.

Stage Three

The third stage of sleep is also an N-REM stage and is often referred to as deep sleep. During deep sleep, your blood pressure drops.

Cell and tissue repair happens during this stage, growth hormone is released, and blood flow increases to muscles.

During this stage, everything slows down. Your heart rate and breathing are very slow, and your brain has long, slow brain waves.

Stage Four

This is the stage of sleep known as the REM state (rapid eye movement). REM sleep increases brain activity causing your eyes to move rapidly behind the eyelids.

This state mimics wakefulness and is the state in which we have and remember our most vivid dreams. REM sleep is important to our ability to learn and to our emotional health.

Types Of Drugs That Keep You Up At Night

There are many different kinds of drugs that keep you up at night. Some of these may be a surprise.

In addition to the effects they have on sleep while they are being abused, people experience poor sleep such as insomnia or difficulty falling asleep during withdrawal.

Alcohol

Alcohol is a central nervous system depressant that has sedative effects on the body that can lead people who drink heavily to fall into a deep sleep quickly.

However, this can create an imbalance between deep sleep and REM sleep. You might think it would cause greater deep sleep, but in fact, it causes longer periods of REM sleep.

It can also lead to increased periods of stage one sleep (wakefulness) as the body eliminates and metabolizes alcohol.

Stimulants

Stimulants are associated with poor sleep, which may seem obvious because of the name. This includes such drugs as methamphetamines, amphetamines, and cocaine.

These drugs tend to have a short high. People who abuse them usually do so in a binge-crash cycle that keeps them awake for long periods of time during the binge part of the cycle.

Marijuana

Some people who use cannabis do so to help them fall asleep. THC is even being explored for possible use as a sleep aid.

However, marijuana has the opposite effect on some individuals. Additionally, withdrawing from heavy marijuana use can cause difficulty falling asleep as well as insomnia.

Opioids

One of the common side effects of opioids and the use of opiates like heroin is heavy sleepiness and drowsiness. However, opioids can disrupt sleep by lengthening transitions between the different stages.

Also, people who are withdrawing from opioid use go through a significant period of insomnia.

How Substance Abuse Affects Sleep

Substance abuse can affect sleep in a variety of ways. This includes the general quality of sleep, sleep deprivation, and other effects.

Sleep Deprivation

One common effect of substance abuse is sleep deprivation.

This is a significant result of the use of stimulants. People who abuse methamphetamines or cocaine often do so in a binge-like manner, taking the drug again as soon as the high wears off.

This can result in long periods without sleep.

Sleep Latency

Sleep latency is the time it takes you to fall asleep. Normal sleep latency lasts about 10 to 20 minutes.

Abuse of certain substances such as alcohol can decrease sleep latency, which can lead to an imbalance in the stages of sleep.

Other substances can increase sleep latency. Side effects of substances can even make it difficult to fall asleep. For example, the itchiness that can result from taking meth or opioids can make it very difficult to fall (and stay) asleep.

Dopamine Levels

Sleep states correspond with neurotransmitter levels, including dopamine. For example, dopamine levels tend to fluctuate in the course of a healthy night’s sleep.

But these levels have also been found to decrease during the day following sleep deprivation. This can create a cycle where people use potent dopamine-increasing drugs that deprive them of sleep. This in turn lowers dopamine levels, which causes susceptibility to reuse or relapse.

Quality Of Sleep

At the very least, substance abuse can affect the quality of your sleep. Such substances as alcohol or opioids may cause you to feel sleepy and fall asleep more quickly, but they can cause an imbalance in your sleep patterns.

Dangers Of Not Getting Enough Sleep

There are dangers of developing chronic health problems that can result from not getting enough sleep (or sleep deficiency).

These can include:

heart disease
high blood pressure
kidney disease
depression and other mental health disorders
stroke
diabetes
obesity

Insomnia Drugs That May Lead To Addiction

Medication for poor sleep may not ultimately be as helpful as one would think. Some medications can be habit-forming and lead to addiction.

Sleep aids such as Ambien (which is a sedative-hypnotic medication) or benzodiazepines are considered controlled substances under the federal Controlled Substances Act for just such a reason.

Symptoms Of Poor Sleep

Poor sleep can broadly affect the central nervous system, causing a wide range of symptoms.

Symptoms of poor sleep can include:

decreased attention span
lack of judgment
decreased ability to make decisions
poor concentration
decreased efficiency at work or school
forgetfulness
poor choices
decreased alertness
decreased reaction time
decreased environmental awareness
reduced memory
moodiness and irritability

How To Improve Sleep Hygiene

However, it is possible to improve the quality of sleep or your sleep hygiene. Withdrawing from substances will often result in poor sleep.

But, once you are in recovery, maintaining good sleep is one of your critical tools for relapse prevention.

Bedtime Routine

One of the most important aspects of sleep hygiene is your bedtime routine. Establishing a structure that governs your bedtime will help you maintain good sleep.

First of all, decide on a bedtime that allows you seven to nine hours of sleep.

Here are some other important parts of a bedtime routine:

go to bed at the same time every night
listen to music to help you relax
have a light snack or a cup of herbal (non-caffeinated) tea before you go to bed
have a relaxation routine
read
write in a journal

These things can help you calm down before going to bed.

Healthy Choices During The Day

Getting good sleep is more than having a good bedtime routine. The choices that help you get a good night’s sleep actually start during the day and can have a lot to do with diet.

For example, you will want to stop drinking caffeinated beverages late in the day or even during the afternoon.

You may also want to watch what you eat as some foods can cause heartburn, which can disrupt your sleep cycle.

Also, have a time during the day when you go outside and get some physical activity, even if it just means going for a walk.

Comfortable Sleep Space

Create a comfortable sleep space for yourself. It doesn’t have to be fancy. The biggest factors are that your room is dark and quiet.

You may also consider other factors like keeping electronic devices out of your room and keeping your room clean.

Avoid Screens Before Bed

As hinted at above, you should avoid any kind of screen time before you go to bed and when you go to bed.

This includes TV, smartphones, video games, etc. You may think that you’ll just watch a show or scroll on your phone until you get sleepy, but that usually just increases wakefulness.

Statistics On Sleep Disorders And Substance Use

Many Americans seem to have poor sleep with about 33% reporting insomnia. Almost 38% fall asleep during the day without intending to.

The use of different substances can cause poor sleep. People in treatment for alcohol use disorder experience poor sleep. This can range broadly between one-quarter and three-quarters of people in treatment.

People in recovery from cocaine addiction, it has been shown, often have poor sleep even though they may think their sleep is getting better.

People who are in recovery for opioid use disorder may have poor sleep if they are undergoing a methadone maintenance program because methadone is an opioid agonist.

Treatment For Substance Use Disorders And Sleep Disorders

If you are in recovery, it is important to take a sleeping disorder seriously because of the connection between poor sleep and the risk of relapse.

The first step is to be sure that you are properly addressing your recovery needs. Psychological, medical, and dual diagnosis needs should all be addressed by your treatment center.

Second, try to stay away from pharmacological solutions to sleep, because many of these can be habit-forming. On the other hand, cognitive behavioral therapy has been shown to positively affect sleep.

If you need to take something, you can consider over-the-counter medication or dietary supplements such as valerian or melatonin.

Importance Of Sleep In Addiction Recovery

The importance of sleep for people in recovery cannot be overstated. Maintaining good sleep is essential to maintaining a positive attitude.

It’s difficult to work on yourself and focus on things like therapy, if you are having a hard time concentrating.

Poor sleep tends to exacerbate symptoms that people in recovery already experience, like difficulty concentrating or a short attention span.

But by considering the sleep hygiene options above, you can strengthen your recovery and reduce your risk of relapse.

Resources For People Battling Substance Abuse And Sleeping Disorders

If you want to know more about healthy sleep and the relationship between sleep disorders and substance use disorders, you can look into the resources below.

The following resources explore healthy sleep:

National Heart, Lung, and Blood Institute, Why Is Sleep Important?: This article gives a thorough overview of the importance of sleep in relation to other aspects of your overall health.
National Heart, Lung, and Blood Institute, What Are Sleep Deprivation and Deficiency?: This article describes sleep deprivation and deficiency and what you need to know about them.
University of Michigan School of Public Health, Sleep 101: Why Sleep Is So Important to Your Health: This article offers a more in-depth look at the important role sleep plays in your overall health.

Here are some resources for more information about getting a good night’s sleep:

Oregon State University, Tips for Getting Good Sleep: Even though this is intended for college students, there are tips here that apply to everyone.
MyHealthfinder, Get Enough Sleep: This is a resource from the Office of Disease Prevention and Health Promotion about actions you can take to get better sleep.
AASM Sleep Education, Healthy Sleep Habits: This resource is recommended by the Centers for Disease Control and Prevention.

The following resources provide information about sleep and drug use: