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Sleep Problems in Recovering Alcoholics

Sleep Disruption Can Continue Long After Quitting

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Updated February 14, 2014

Using alcohol as a sleep aid is somewhat of a paradox: although alcohol can initially help someone fall asleep, it can also disrupt sleep in the latter part of the night. Clinicians already know that alcoholics often have significant sleep problems both while actively drinking as well as after they've stopped drinking.

A study in the August 2003 issue of Alcoholism: Clinical & Experimental Research has found that alcoholics can continue to have sleep problems for many months after they quit drinking, that problems with sleep onset may be more pronounced than with sleep maintenance, and that many former alcoholics had sleep problems that predated the onset of alcohol dependence.

"Three or more drinks will cause the average person to fall asleep sooner than usual," said Shawn R. Currie, adjunct assistant professor , cross-appointed in psychiatry and psychology at the University of Calgary, and corresponding author for the study. "However, falling asleep faster is the only real benefit of alcohol for sleep. The more prevalent, disruptive effects include more frequent awakenings, worse sleep quality; reduction of deep sleep, and earlier-than-usual waking times, leading people to feel they did not get enough sleep."

An alcoholic who is actively drinking experiences similar, but more severe, types of sleep disruptions. An alcoholic who quits drinking often experiences sleep problems in the two to six months of abstinence following withdrawal. "They take a long time to fall asleep, have problems sleeping through the night, and feel their sleep is not restorative," said Currie. "Lab research supports claims of sleep disruption; overnight-sleep studies have documented reductions in deep sleep and abnormalities in REM sleep in persons with more than a year of sobriety."

"Sleep has a reputation among the recovering community of being one of the last things that fall back into place for an individual," added David Hodgins, professor of psychology at the University of Calgary. "It's also recognized as a potential precipitant of relapse. In the 12-step community, there's a little saying that describes the risk factors for relapse; it's called HALT. People who are Hungry, Angry, Lonely or Tired are at an increased risk of relapse. Certainly, one way a person can be tired is through sleep disruptions."

For this study, researchers examined 63 alcoholics in recovery (44 men, 19 women) who were experiencing insomnia. All underwent a multimodal sleep assessment that included a structured interview, daily sleep diaries, questionnaires, and sleep monitoring via actigraph recordings (an actigraph is a small, lightweight monitor that is worn on the non-dominant wrist, providing continuous recording of movement in the participant's natural sleep environment). Participants were further divided into two groups: those with short-term (less than 12 months) and long-term (more than 12 months) abstinence.

Part Two: Insomnia in Alcoholics

Source: Alcoholism: Clinical & Experimental Research News Release

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