How Better Sleep Helps Your Chances for Successful Recovery

On average, we spend about one-third of our lives sleeping. Sleep is key factor in our health and well-being.

Why Sleep is Important?

Sleep allows the central nervous system to rest and restore itself. Sleep is important for regulating body cycles, processing information, creating and storing memories, and aiding in creative thinking. Adequate sleep is also important for warding off inflammatory processes in the body. Adequate sleep (defined as 6 or more hours for most adults) is associated with diminished presence in the body of a protein that indicates inflammation. Inflammation is linked to many physical issues including heart disease, stroke, diabetes, arthritis, and premature aging.

Lack of quality sleep can even affect our emotions. A 2015 study in the Journal of Neuroscience reported that lack of sleep affects both cognitive (thinking) and emotional processes, resulting in a tendency toward increased irritability, reduced mental focus and a heightened sense of emotional reactivity and stress.

Insomnia

Unfortunately, the use of alcohol and drugs is one of the most common ways that sleep patterns get disrupted and insomnia, or an inability to have regular, restful sleep, takes over.

According to a study by the National Institutes of Health (NIH), almost 75 percent of recovering alcoholics reported sleep problems immediately following detox. Some of the problems experienced with insomnia include:

• Trouble getting to sleep
• Waking up multiple times throughout the night
• Waking up and not being unable to get back to sleep
• Disturbing dreams
• Sleeping too much
• Not feeling refreshed after sleep

Substance Abuse and Insomnia: A Vicious Cycle

A vicious cycle of substance abuse and insomnia can start if one tries to self-medicate with alcohol to rid themselves of insomnia. Studies consistently indicate that about 25-30% people who have insomnia have used alcohol to help them fall asleep.  Alcohol is one of the most commonly used substances to fight insomnia because of its depressant qualities, which produce relaxation and sleepiness. However, these effects are short-lived and the use of alcohol soon begins to disrupt natural, healthy sleep patterns. People who regularly drink alcohol before bedtime wake up more often during the night and have trouble going back to sleep.

Alcohol also creates chemical dependencies within the body and its sudden withdrawal causes disruptions in the body’s circadian rhythm, or natural physiological patterns of sleep and wake cycles. This is why insomnia often gets worse during early recovery. An NIH study found that after five months of abstinence, people in treatment for alcohol use disorders who were still reporting disturbed sleep were approximately twice as likely to have relapsed than those whose sleep had normalized by this time.

Other substances affect sleep quality as well.  Stimulants, such as cocaine, disrupt sleep patterns by making it hard for the body to return to a state of calm that necessary for sleep to be initiated. Marijuana interacts with certain chemicals in the brain, producing changes in brain wave patterns and REM (rapid eye movement) sleep cycles that are necessary for restful, restorative sleep.

Dangers of Insomnia for Those in Recovery

Insomnia in early recovery can lead to a number of problems, including:

• Depression
• Anxiety
• Irritability and moodiness
• Loss of energy
• Increased risk of relapse

Do You Have Poor Quality Sleep?

An occasional restless night does not cause lasting problems. But persistent sleep disturbances should be reported to your doctor or therapist for possible intervention. The Pittsburgh Sleep Quality Index (PSQI) is a self-administered sleep quality questionnaire that can be found here.

The PSQI differentiates “poor quality sleep” from “good quality sleep”, as measured by seven components, including sleep duration, sleep disturbances, use of sleeping medications, daytime consequences and more, over a month’s duration.

If you score “5” or higher on the nine questions, it is recommended that you seek guidance from a healthcare professional for your sleep issues.

Tips for Better Sleep

• Create a good sleeping environment: Make sure that your bed is comfortable, the room is quiet and dark, and the temperature and ventilation are comfortable. You might consider a “white noise generator” if you need to reduce noise in the environment.
• Create and maintain a consistent sleep schedule: Set a consistent time period for going to bed and getting up, including on weekends, and avoid daytime napping. This will help you readjust your circadian rhythms.
• Monitor your food and drink intake: Avoid eating a large meal just before bedtime and eliminate or reduce caffeine intake (particularly after 3 pm). Drinking warm milk before bedtime helps some people fall asleep faster.
• De-stress and relax before you retire: Exercise early in the day, not in the evening. Listening to some relaxing music or a guided meditation can help you “dial down” your brain and prepare it for sleep.
• Don’t take your worries to bed: If you are in the habit of reflecting on and mentally processing problems during the night, keep a pad and pencil by your bed, so you can jot down a few notes. This will help you recall, in the morning, memories about the issue you were worrying about during the night. By “tabling” the issue for later, you will help your mind let go of the worry, so you can relax back into sleep. You can also note any troublesome thoughts, dreams, etc. that you can later discuss with your counselor or peer recovery group members.
• If you can’t get to sleep within 30 minutes of going to bed: Get out of bed and do something relaxing in low light until you feel sleepy; then go back to bed.