Sleep Problems Associated With Alcohol Misuse

Why Can't I Sleep While Sober?

Tired woman taking a nap in a cafe
EujarimPhotography / Getty Images
Table of Contents
View All
Table of Contents

Many people with alcohol use disorders also have sleep problems. If you drink to excess, even occasionally, you have probably experienced sleep problems.

Such problems can persist for some time even after you decide to quit drinking. In fact, difficulty sleeping is one of the most common alcohol withdrawal symptoms and one that causes many to relapse.

This article discusses how alcohol affects sleep and the disruptions you might continue to experience after you quit drinking. It also explores why you might feel like you can't sleep sober and what you can do to cope.

If you or a loved one are struggling with substance use or addiction, contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-4357 for information on support and treatment facilities in your area.

For more mental health resources, see our National Helpline Database.

Types of Alcohol-Related Sleep Problems

According to the Substance Abuse and Mental Health Services Administration (SAMHSA), 25% to 72% of people with alcohol use disorders report sleep troubles. The more prevalent, disruptive effects include:

  • More frequent awakenings
  • Worse sleep quality
  • Reduction of deep sleep
  • Earlier-than-usual waking times

Such effects lead people to feel that they did not get enough sleep. Daytime sleepiness, reduced concentration, irritability, and other symptoms can then result.

Studies have found that sleep problems can last for weeks, months, or even years after quitting drinking. In many cases, people recovering from alcohol use typically have more problems with sleep onset than with sleep maintenance

Many people who are recovering from alcohol use disorders had sleep problems that predated their alcohol dependence.

Unfortunately, recovery and abstinence are more challenging if you aren't able to get enough good-quality sleep. Difficulty sleeping, particularly when a person feels that they can't sleep sober, may increase the risk that they will relapse.

Non-Restorative Sleep

People in alcohol recovery take a long time to fall asleep, have problems sleeping through the night, and feel that their sleep is not restorative.

Alcohol withdrawal leads to reductions in deep sleep and abnormalities in REM sleep. REM sleep is characterized by increased brain activity, relaxation of the body, rapid eye movements, and increased dreaming.

Sleep problems are often viewed as one of the last things to improve among people in alcohol recovery. It is also a symptom that poses a significant risk for relapse.

In fact, 12-step recovery programs often refer to the factors that increase a person's risk for relapse as HALT, standing for Hungry, Angry, Lonely, or Tired. Sleep disruptions may increase the risk that a person will feel tired, which might cause a person to reach for a drink if they feel like they can sleep sober.

Insomnia

Insomnia is a common problem for many adults, but it is not uncommon to experience it in the short-term and long-term after quitting drinking. It is characterized by difficulty falling or staying asleep, which can lead to daytime drowsiness, trouble concentrating, and other negative health effects.

People in recovery are often more likely to have problems with sleep onset than with sleep maintenance, which is why some might conclude that they can't sleep sober.

Types of Insomnia

  • Onset insomnia: Trouble falling asleep
  • Maintenance insomnia: Inability to sleep through the night (wake up and can't fall back to sleep)
  • Acute insomnia: Brief period of trouble sleeping, often caused by a stressful life event or experience
  • Chronic insomnia: Problems falling or staying sleeping at least three nights per week for three months or longer
  • Comorbid insomnia: Occurs with another condition, like depression or anxiety, that also interferes with sleep

Insomnia is also common among people who have an alcohol use disorder, but the problem can persist or even begin during recovery. However, it is also important to note that many people experiencing insomnia during withdrawal and recovery also had insomnia before they became dependent on alcohol.

Treatment for Insomnia

The first treatment for insomnia in recovery is sobriety, and many patients will see improvement. For the specific treatment of insomnia, behavioral therapies are the preferred treatment (rather than medications), as they have been shown to be effective and they won't interfere with sobriety.

Cognitive Behavioral Therapy for Insomnia (CBT-I)

The goal of cognitive behavioral therapy for insomnia (CBT-I) is to change sleep habits as well as any misconceptions about sleep and insomnia that may perpetuate sleep difficulties.

CBT-I often entails regular, weekly meetings, during which your therapist will give you sleep assessments, work with you to alter problematic sleep behaviors, and ask you to complete a sleep diary at home.

Sleep Restriction

This type of behavioral therapy works to improve your sleep efficiency, or the time you spend asleep divided by the time you spend in bed. The idea behind sleep restriction is that by limiting the amount of time you allow yourself to sleep and stay in bed, you'll increase your desire to sleep (called sleep drive) and sleep less fitfully and more efficiently.

Medication

There are many medications used to treat insomnia, including benzodiazepine and nonbenzodiazepine medications. If you're in recovery, your healthcare provider will need to weigh the risks and benefits of prescribing these medications for insomnia. There are also some relapse-prevention medications that can help promote sleep.

Complementary Therapy

Numerous complementary therapies have been used to treat insomnia in people in recovery, including:

Coping With Alcohol-Related Sleep Problems

Working on your sleep hygiene is another way to help prevent or reduce insomnia. These are changes you can make to your environment and routine to help promote sleep.

  • Develop a relaxing bedtime routine. Whether you write in a journal, use a meditation app, or wind down with a warm bath, doing something calming prior to lights out will help set the tone for solid slumber.
  • Keep your room dark, cool, and comfortable. Avoid the use of television, cell phones, computers, or e-readers in your bedroom. The blue light from these electronic devices can suppress the body's sleep-inducing hormone melatonin and interfere with your internal body clock. The National Sleep Foundation recommends keeping your room cool (around 65 degrees Fahrenheit) and using light-blocking curtains, shades, or blinds to keep your bedroom dark.
  • Keep a regular sleep/wake schedule. This will enable your body to get used to a certain bedtime and then be ready to sleep at that time.
  • Avoid napping. Naps decrease your overall amount of sleep debt, making it more difficult to fall asleep again at night at the proper time. 
  • Refrain from stimulants in the evening. Stimulants that disrupt sleep include caffeine (coffee, tea, soft drinks, chocolate) and nicotine. According to a study published in Psychology, Health & Medicine, the average person loses more than one minute of sleep for every cigarette they smoke.

Press Play for Advice On Sleep Hygiene

This episode of The Verywell Mind Podcast, featuring neurologist and sleep expert Chris Winter, shares strategies for sleeping better at night. Click below to listen now.

Follow Now: Apple Podcasts / Spotify / Google Podcasts / Amazon Music

A Word From Verywell

Alcohol can have a detrimental impact on sleep, but these problems can also persist once you decide to stop drinking. Finding ways to cope with insomnia and other sleep issues is important since poor sleep can be a risk factor for alcohol relapse.

Fortunately, there are treatments and coping techniques that can help you get better rest, which can help you feel better during alcohol recovery. If you are experiencing sleep problems, be sure to talk to your doctor about your options.

13 Sources
Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Colrain IM, Nicholas CL, Baker FC. Alcohol and the sleeping brainHandb Clin Neurol. 2014;125:415-431. doi:10.1016/B978-0-444-62619-6.00024-0

  2. Substance Abuse and Mental Health Services Administration. Treating Sleep Problems of People in Recovery from Substance Use Disorders. SAMHSA In Brief. 2014;8(2).

  3. Roehrs TA, Auciello J, Tseng J, Whiteside G. Current and potential pharmacological treatment options for insomnia in patients with alcohol use disorder in recoveryNeuropsychopharmacol Rep. 2020;40(3):211-223. doi:10.1002/npr2.12117

  4. Roehrs TA, Roth T. Sleep disturbance in substance use disorders. Psychiatr Clin North Am. 2015;38(4):793-803. doi:10.1016/j.psc.2015.07.008

  5. Koob GF, Colrain IM. Alcohol use disorder and sleep disturbances: a feed-forward allostatic frameworkNeuropsychopharmacology. 2020;45(1):141-165. doi:10.1038/s41386-019-0446-0

  6. Martindale SL, Hurley RA, Taber KH. Chronic alcohol use and sleep homeostasis: risk factors and neuroimaging of recovery. JNP. 2017;29(1):A6-5. doi:10.1176/appi.neuropsych.16110307

  7. Melemis SM. Relapse prevention and the five rules of recoveryYale J Biol Med. 2015;88(3):325-332.

  8. Geiger-Brown JM, Rogers VE, Liu W, Ludeman EM, Downton KD, Diaz-Abad M. Cognitive behavioral therapy in persons with comorbid insomnia: A meta-analysis. Sleep Med Rev. 2015;23:54-67. doi:10.1016/j.smrv.2014.11.007

  9. Rossman J. Cognitive-behavioral therapy for insomnia: An effective and underutilized treatment for insomnia. American Journal of Lifestyle Medicine. 2019;13(6):544-547. doi:10.1177/1559827619867677

  10. Maurer LF, Schneider J, Miller CB, Espie CA, Kyle SD. The clinical effects of sleep restriction therapy for insomnia: A meta-analysis of randomised controlled trialsSleep Med Rev. 2021;58:101493. doi:10.1016/j.smrv.2021.101493

  11. Brower KJ. Assessment and treatment of insomnia in adult patients with alcohol use disorders. Alcohol. 2015;49(4):417-427. doi:10.1016/j.alcohol.2014.12.003

  12. National Sleep Foundation. What Temperature Should Your Bedroom Be?

  13. McNamara JP, Wang J, Holiday DB, et al. Sleep disturbances associated with cigarette smoking. Psychol Health Med. 2014;19(4):410-419. doi:10.1080/13548506.2013.832782

By Buddy T
Buddy T is a writer and founding member of the Online Al-Anon Outreach Committee with decades of experience writing about alcoholism. Because he is a member of a support group that stresses the importance of anonymity at the public level, he does not use his photograph or his real name on this website.