One of the most common myths for both drinkers and non-drinkers is that alcohol does not interfere with sleep. So how does it interfere with sleep? About 20% of Americans use alcohol to help them relax, and an estimated 10 million people seek medical attention for sleep disorders. While alcohol helps us fall asleep quicker, it also keeps us from entering REM sleep, which is the restorative form of sleep. REM sleep is also where we dream, and it is essential for proper brain activity and emotional well-being.
Most of us are aware that alcohol will help us fall asleep, but what happens when a drink to fall asleep is not well understood. Alcohol disrupts our sleep in many ways, leaving us exhausted and drowsy the next day.
A Normal Sleeping Pattern
Sleep is divided into two phases: rapid eye movement (REM) and non-REM sleep. Non-REM sleep has four stages. We start with light sleep, where we can quickly be woken, and progress to intermediate sleep. The stages of sleep are medium, intermediate, and deep.
We undergo the first phase of REM sleep after a deep sleep, and then REM and non-REM alternate in 90-minute intervals for the rest of the night. Several regions of the brain are active in sleep. The hypothalamus and pineal gland are two important players. The suprachiasmatic nucleus (SCN) of the hypothalamus is made up of thousands of cells that obtain information about light sensitivity from the eyes. This aids us in syncing our circadian rhythm with the light-dark period.
What Effect Does Alcohol Have on Sleep?
Less Melatonin Production
Using alcohol within an hour of going to bed will reduce melatonin output by 20%. Melatonin is what makes us sleepy, but if we produce less melatonin, we would have a harder time sleeping. Alcohol is shown to decrease sleep latency, which means we fall asleep quicker than if we didn’t drink. What really happens is that we skip light and intermediate sleep and head right to heavy sleep in the first half of the night.
We Spend Less Time in REM Sleep
Our capacity to enter REM sleep, which is the restorative sleep in which we dream, is disrupted by alcohol, particularly in the first half of the night. A rebound reaction occurs when alcohol is absorbed by the body, impairing our ability to fall asleep deeply. Deep sleep is essential for bone, blood, and immune system health. We wake up sometimes when we are unable to reach deep sleep in the second half of the night. The quicker it is to wake up, the lighter we sleep. This is so all of us experience a jolt between the hours of 2-3 a.m.
We have multiple cycles of REM sleep during a typical night’s sleep, but just one or two during a night of drinking. This makes us wake up weary, even though we have been in bed for a long time.
In general, we sleep less.
Drinkers, quite without exception, sleep less than non-drinkers, according to most surveys. In addition to disrupting our bedtimes, alcohol is a diuretic, causing us to wake up often to use the restroom. After a night of drinking, one may experience insomnia and restlessness the following day.
Sobriety Improves Sleep
After 5-6 days of sobriety, REM resumes. This suggests that there are further intervals of REM sleep and a shorter time between REM and non-REM sleep. Abstinence will increase total sleep time. One research tracked and observed participants in weeks 19, 14, and 27 months of sobriety. During the first year of treatment, they discovered that overall sleep time improved.
Dreaming aids us in processing our emotions. If you are stressed or anxious, you will more likely have more dreams. Although we can dream at any point of sleep, REM sleep has the most vivid dreams.
We have depression and anxiety from leaving alcohol, as well as rebound REM sleep, in early recovery (remember, we have more vivid dreams during REM). Any of these factors increase the risk of having dreams over alcohol. A relapse dream research conducted by Massachusetts General Hospital included over 2,000 individuals who had recovered from serious alcohol or opioid use. Researchers discovered that about one-third of the patients had relapse dreams, which decreased the longer the individual was in rehab.
Relapse dreams occur when a person drinks or ingests their drug of choice. When the dreamer awakens, they are in disbelief and overwhelmed by fear, remorse, and shame. These hallucinations can feel so intense that the individual feels they have relapsed for a brief moment.
John Kelly, the study’s author, explains:
“The association between the decreasing frequency of these dreams and the length of time in recovery suggests that, as the body and mind gradually adapt to abstinence and a new lifestyle, psychological angst about relapse diminishes. REM sleep and deep wave sleep undergo important changes, even long after people enter recovery, and these relapse dreams may be indicative of the healing process and brain-mind stabilization that occurs with time in recovery.”
Therefore, how does alcohol interfere with sleep? Although alcohol can help us fall asleep quicker, it disrupts our sleep throughout the night. We skip medium, intermediate, and REM sleep, thus sinking into a deep sleep in the first half of the night. We enter REM rebound when we metabolize alcohol, making it very difficult to return to deep sleep. Since alcohol decreases the amount of melatonin our bodies make, we become less sleepy in addition to repeated bathroom visits.
Sleep improves over the first year of sobriety, according to studies, but with sobriety comes the possibility of having dreams about alcohol. These dreams can be disturbing and intense, but they tend to fade as we spend more time sober.