Sleep is often one of the first things that people let fall by the wayside when they’re pressed for time. However, it doesn’t take more than a few nights of bad sleep to realize how essential rest is to physical and mental health. After a night of tossing and turning you may wake up groggy, exhausted and eager to catch up on the rest you missed. If you have an active substance use disorder or are just beginning the process of recovery, a good night’s sleep may be even more essential (and elusive) than you think. Studies show that drug and alcohol use or withdrawal can dramatically decrease sleep quality, which in turn can make it more difficult to resist cravings and fully commit to recovery.
Whether you’re new to the recovery process or struggling to begin it, it’s important to recognize the ways sleep can impact your sobriety. This Sleep Awareness Week (March 11–17, 2018) is the perfect opportunity to reflect on the importance of sleep, and the dangerous ways that the use of particular substances can affect sleep quality and impede recovery.
The Stages of Sleep
To understand how drugs and alcohol can be detrimental to sleep quality, it’s important to understand how sleep works. Throughout the course of a night, most sleepers pass through five stages of sleep: stage 1, stage 2, stage 3 and rapid eye movement (REM). Ideally, people progress through these stages cyclically from stage 1 to REM, and back to stage 1. Each sleep cycle typically lasts an average of 90 to 110 minutes, with the time spent in each stage varying as the night progresses.
Every stage of sleep serves a unique and essential function:
- Stage 1: This stage is the lightest of all five stages, and typically lasts for 5 to 10 minutes. Eye movement and muscle activity begin to slow as the body relaxes. During stage 1 sleep, many people experience sudden muscle contractions that are often preceded by a sensation of starting to fall.
- Stage 2: Eye movement stops and brain waves begin to slow as heart rate and body temperature drop. This light sleep stage begins to prepare the body for deep, rejuvenating rest.
- Stage 3: This stage marks the body’s transition from light sleep to deep, restful sleep. During this stage, the body repairs damaged tissues, builds new bone and muscle tissue and strengthens the immune system. It is difficult to wake up during stage 3 sleep. If you do, you’ll likely feel disoriented for a few minutes.
- REM: The brain and body are incredibly active during REM sleep. Heart rate and breathing quicken. Brain activity increases. As the name REM suggests, the eyes move back and forth quickly. This is the stage of sleep where dreaming occurs. REM sleep is essential to learning, as it helps brain transfer information from short term to long-term memory.
While much is still unknown about the ways that sleep works, one thing is clear: high-quality sleep is essential to psychological and physical health. It’s also clear that the use of most addictive substances can be detrimental to sleep, which may feed into the cycle of addiction and make it harder to stay in recovery.
The Interplay Between Sleep and Substances
While the early stages of sleep are important, stage 3 and REM sleep are essential. This is the time when the body heals itself, and the brain incorporates new information learned throughout the day. Addictive substances have such a dramatic impact on sleep quality because they impact the body’s ability to enter long periods of stage 3 and REM sleep. One study found that people with an active substance use disorder are five to ten times more likely to develop a sleep disorder.
Different substances impact sleep quality in different ways:
- Alcohol: While alcohol is often thought of as a sedative or calming drug, it’s detrimental to sleep quality. Drinking can induce sleep, but the quality of sleep is often lower, particularly in the second half of a person’s sleep period. The number of times you wake up in the later half of the night increases, which keeps you in lighter sleep stages and prevents you from getting the REM sleep you need. Many of the symptoms of a hangover can actually be attributed to lack of sleep.
- Cocaine: Because cocaine floods the brain with dopamine, it increases wakefulness and suppresses REM sleep long after the drug is ingested. Chronic cocaine use can also alter the structures in the brain that control sleep-wake cycles, further disrupting the body’s natural sleep cycle.
- Ecstasy: Using ecstasy (aka “molly”) even once can have dramatic impacts on sleep. According to a study published in Psychopharmacology, rats given a single dose of MDMA (the chemical name for ecstasy) experienced the modifications of two genes essential to maintaining the body’s natural sleep rhythms. According to Dr. Ogeil, the doctor who led the study, MDMA has a similar effect on human users, causing irregular sleep or low quality sleep for months after ingesting the drug.
- Opioids: Because opioids like morphine, hydrocodone and heroin have powerful sedative properties, many people believe that they aid in sleep. The reverse is true. Studies have found that people taking opioids experience significantly disrupted sleep through every cycle of sleep. For those taking opioids to deal with pain, this can be doubly detrimental. Paradoxically, sleep is already significantly disrupted in individuals who deal with chronic pain, and high-quality sleep is essential to healing and repairing the body.
Unfortunately, sleep isn’t only affected when a person is actively using a substance. Sleep quality can continue to suffer after a person has discontinued drug or alcohol use, especially during the detox process. This presents a troubling problem, as lower sleep quality can actually increase drug cravings for those going through withdrawal, according to a study conducted by researchers at Penn State.
If you’re new to recovery, it’s crucial that you get adequate, restful sleep as often as you can. If you struggling to break free from addiction, don’t take for granted how much poor sleep quality may be getting in the way of your ability to begin the path to recovery. And if you need help, The Recovery Village is here. With evidence-based treatment and locations across the country, we can connect you to hope and healing. Reach out to an intake coordinator today for more information.