Drug And Alcohol Related Sleep Disorders

Alcohol related sleep disorder typically occurs as the insomnia type.

Drug use, drug abuse, and withdrawal from drug abuse cause sleep disturbances.

Sleep disturbances also have been linked to the use of alcohol and to chronic alcoholism.

REM Sleep

Alcohol, which often facilitates sleep onset, can lead to reduced REM sleep and sleep disturbance. Acute intoxication initially results in increased sleepiness and reduced alertness for 3-4 hours.

An increase in stages 3 and 4 of NREM sleep is a typical feature of this initial stage. Following these initial effects, increased sleeplessness, restless sleep, and, often, vivid and anxiety-laden dreams during the second half of the night are experienced by the individual.

In addition, alcohol can increase the number of obstructive sleep apnea events and result in fragmented sleep. With continued habitual use, alcohol continues to show a short-lived sedative effect for several hours, followed by sleep continuity disturbance for several hours.

Caffeine

Caffeine is known to result in increased wakefulness and sleep fragmentation, which may be documented on a polysomnogram test as extended sleep latency, multiple arousals, and a reduction in slow-wave sleep.

Cocaine

Use of cocaine results in increased sleep latency, reduced total sleep time, and breakup of sleep architecture during intoxication. Cocaine withdrawal is associated with hypersomnia.

Amphetamines

During the stage of acute intoxication, amphetamines produce sleep disruption associated with increased sleep latency, fragmented sleep, reduced total sleep time, an increase in body movements, and a reduce in REM sleep.

Slow-wave sleep tends to be reduced. During withdrawal from long-term amphetamine use, hypersomnia with prolonged nocturnal sleep duration and excessive daytime sleepiness tends to be the rule.

Sedative Hypnotic Medications

Use of sedative-hypnotic medications produces an increase in sleepiness and polysomnographic findings of decreased REM sleep and an increase in sleep-spindle activity. On the other hand, long-term use of sedatives may be accompanied by symptoms of insomnia and tolerance to these medications.

Alcohol's sleep-inducing effect may decrease as its disruptive effects continue or increase with continued consumption just before bedtime. The sleep disruption resulting from alcohol use may lead to daytime fatigue and sleepiness.

Bedtime alcohol consumption among older adults may lead to unsteadiness if walking is attempted during the night, with increased risk of falls and injuries.

The elderly are at particular risk for alcohol-related sleep disorders because they achieve higher levels of alcohol in the blood and brain than do younger adults after consuming an equivalent dose.

Prescription drugs that may cause sleep problems include:

• Diet pills
• Some antidepressants
• Respiratory medications
• Steroids including prednisone
• High blood pressure medications
• Hormones such as oral contraceptives
• Attention deficit/hyperactivity disorder medications

After acute alcohol withdrawal in chronic abusers, sleep is best improved by behavioral techniques such as regularizing the sleep/wake schedule, avoiding daytime napping and avoiding the use of nicotine and caffeine. Despite behavioral therapy, many recovered alcoholics continue to complain of poor sleep.

Self Care:

• Don’t sleep in late on weekends and don't drink alcohol after 6 p.m.
• Don't drink any alcohol within four to six hours of bedtime if you want a good night’s sleep.
• As a lifestyle change to make your sleep more restful, avoid alcohol in the late afternoon and evening.