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Drug abuse degrades sleep quality, making sleep problems worse.
The Link Between Sleep-Wake Disorders & Substance Abuse
Sleep-wake disorders are a group of conditions that lead the body’s circadian rhythm to be out of sync with one’s surroundings or community. This can lead to physical and mental problems.
Abusing drugs and alcohol can influence when you fall asleep and wake up too. This is not just because of the drug’s immediate effects on the body, but also due to long-term changes in the brain that may cause chronic illness.
Sleep-wake disorders are sleep problems that occur when the body’s natural circadian rhythm does not line up with the sleeping and waking cycles of most people or does not match up to daytime and nighttime hours.
Having a circadian rhythm that is out of sync with one’s surroundings or loved ones can be stressful in the short term. In the long term, sleep-wake disorders influence eating patterns and body weight, hormonal cycles, and body temperature.
If you have a sleep-wake disorder, you may have trouble falling asleep and waking up at times that are considered normal in your society. This could be temporary, such as problems that are due to travel or a change in work schedule.
It could also be a permanent condition. This can cause immense stress because your natural sleep cycle does not match up with your work schedule or when your friends and family are awake.
A sleep-wake disorder can be a very isolating condition. People who suffer from them often feel lonely and depressed.
Diagnosing a sleep-wake disorder may involve a sleep test.
Primary care reports find that between 10 and 20 percent of people complain about significant sleep problems. About a third of adults report insomnia, with about 6 to 10 percent meeting the criteria for an insomnia disorder. This could be caused by an underlying sleep-wake disorder.
Types of sleep-wake disorders include:
Some conditions may require adherence to sleep hygiene and quitting use of most drugs and alcohol. In other cases, you may need specific medications to keep you awake at certain hours and to help you sleep at others. Exposure to ultraviolet (UV) light and taking melatonin supplements work for most moderate sleep-wake disorders.
More on Sleep Disorders
More on Sleep Disorders
Sleep abnormalities like insomnia caused by sleep-wake disorders are associated with substance abuse. People who have sleep-wake disorders may begin abusing sedative medications or alcohol to force themselves to sleep, while those who abuse stimulant drugs may develop sleep disorders because they stay awake for days at a time.
About 70 percent of people admitted to addiction treatment programs reported a sleep problem prior to their admission.
Roughly 80 percent of that group reported that the sleep problem was directly associated with substance abuse.
The relationship between these two conditions appears to be bidirectional, with one leading to the other. Each condition exacerbates the other.
Chronic sleep-wake disorders cause sleep loss, feelings of inadequacy, and work or social struggles. For most people, using light exposure therapy, taking melatonin supplements, or using sleep hygiene to manage a regular sleep schedule can greatly help.
Sleep deprivation that is caused by forcing the circadian rhythm into an unnatural or unfamiliar rhythm can seem like insomnia, which can add to stress. That can then trigger substance abuse.
At the same time, there are some drugs that can trigger these sleep-wake disorders or make them worse. Drugs that are associated with chronic sleep problems include:
Alcohol decreases sleep latency, so people usually fall asleep faster after drinking. But it prevents deep sleep, which allows for rapid eye movement (REM) cycles at night. This means the quality of the sleep is poorer despite falling asleep more quickly. Poor-quality sleep means stress and anxiety, and this often leads to drinking more as a method of self-medication.
People who have a sleep-wake disorder where they feel tired all the time or have trouble falling asleep at night may self-medicate with alcohol; however, this will make their sleep condition worse.
Whether a person abuses substances and develops sleep problems, or has sleep difficulty and self-medicates to manage it, both sleep-wake disorders and substance abuse feed into each other. Drugs and alcohol lower the quality and amount of sleep, changing when you fall asleep and wake up, and being unable to fall asleep or get up at a normal time makes self-medicating behaviors worse.
This makes recovery harder. You may feel like you need a stimulant to stay awake or a sedative to fall asleep.
People who have specific circadian rhythm disorders that are not temporary can get treatment from a sleep specialist. For most people, however, taking sedatives and stimulants is not an appropriate medical solution. Instead, managing circadian rhythms with UV light therapy, melatonin supplements, and a regular sleep schedule is the best approach to treatment.
Because sleep disorders are so closely associated with substance abuse, more detox and rehabilitation programs are screening for these conditions so they can be treated concurrently. Co-occurring disorders should be fully addressed in addiction treatment, including during detox, since insomnia and hypersomnia are both associated with withdrawal symptoms.
With comprehensive treatment, those who struggle with substance abuse and sleep-wake disorders can effectively achieve recovery. By addressing both conditions, the chances of relapse are reduced.
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What Are Sleep Disorders? (July 2017). American Psychiatric Association (APA).
Jet Lag Disorder. (September 2018). Mayo Clinic.
Advanced Sleep-Wake Phase – Overview & Facts. American Academy of Sleep Medicine (AASM).
Non-24-Hour Sleep-Wake Rhythm – Overview & Risk Factors. American Academy of Sleep Medicine (AASM).
Irregular Sleep-Wake Rhythm – Overview & Symptoms. American Academy of Sleep Medicine (AASM).
Sleep Abnormalities Associated with Alcohol, Cannabis, Cocaine, and Opiate Use: A Comprehensive Review. (April 2016). Addiction Science & Clinical Practice.
Insomnia and Alcohol and Substance Abuse. Office of Alcoholism and Substance Abuse Services, New York State.