For many, especially those with severe alcohol use disorder, there is a common belief that a drink before bed will help with sleep, making it easier to fall asleep more quickly. However, drinking alcohol, especially at a high volume and frequency, has been demonstrated to have significant negative effects on the quality and duration of sleep. The lack of sleep that results can have serious consequences, ranging from the more direct (impaired occupational function and memory deficits) to the long-term (increased risk for depressive disorders and heart disease).
While it can be true that alcohol’s sedating effects may initially reduce the amount of time required to fall asleep, its continued presence in the body has significant negative impacts on the processes of sleep. First, research has shown that alcohol consumed before bedtime disrupts the second half of the sleep period, leading people to wake from their dreams and be unable to fall back asleep. There is evidence that “before bedtime” can extend up to six hours before an individual falls asleep, meaning that “happy hour” drinking can have the same effect as a drink immediately before bed. Older adults, who are more affected by alcohol consumption and already are more likely to have sleep-related issues, are also at increased risk of falls and injuries when waking up in the middle of the night.
Furthermore, chronic alcohol use has been associated with an increased risk for sleep apnea, a disorder where interrupted breathing caused by narrowed upper air passages can lead to hundreds of brief episodes of awakening a night, reducing sleep time. Drinking alcohol can on its own lead to a narrowing of the upper air passage, meaning that chronic alcohol users who otherwise have no sleep-related issues can display symptoms of sleep apnea. Research has shown that chronic alcohol users with sleep apnea are much more likely to be involved in fatigue-related traffic accidents.
Individuals with severe alcohol use disorder are especially affected by sleep disturbances, suffering from further decreases in quality sleep, more frequent awakenings, and daytime fatigue. Over time, it will take longer for a chronic alcohol user to fall asleep. Unfortunately, when heavy alcohol consumption is suddenly ceased, alcohol withdrawal syndrome can have significant negative impact on sleep as well, leading to insomnia and more frequent awakenings. The belief that resuming consumption can improve this is what leads many to relapse, but the relief experienced is only temporary as sleep quality reverts to its former baseline. Overall, the research shows alcohol and quality sleep are not compatible.
Andrew Smith, Intern