Saturday, April 27, 2013

SATURDAY REWIND: Alcohol is, and isn't, a sleep aid

Alcohol is a fairly efficient, cheap and readily accessible central nervous system depressant.  Even though some people react with euphoria or aggression while under the influence, alcohol is a sedative.  It does help put a person to sleep. But as this January article from my archive points out, alcohol does nothing for the quality of sleep, potentially leading to health problems, even for non-alcoholics.

A review of several sleep studies, including one reported on last December, bashes myths about alcohol aiding sleep. Results will be published in the April 2013 issue of Alcoholism: Clinical & Experimental Research but were released January 22 online.

"Certainly a mythology seems to have developed around the impact of alcohol on sleep," said Chris Idzikowski, director of the Edinburgh Sleep Centre. "It is a good time to review the research as the mythology seems to be flourishing more rapidly than the research itself."

The study confirms that people do fall asleep quicker under the influence and alcohol increases deep sleep in the first half of the night, but has a major impact on rapid eye movement (REM) sleep. REM sleep is important to physical health, metabolism and mental health.  Lead researcher Dr. Irshaad Ebrahim concluded. "The higher the dose, the greater the impact on increasing early sleep. This effect on the first half of sleep may be partly the reason some people with insomnia use alcohol as a sleep aid. However, the effect of consolidating sleep in the first half of the night is offset by having more disrupted sleep in the second half of the night."

Both Ebrahim and Idzikowski hope this review will improve understanding that short-term alcohol use only gives the impression of improving sleep, and it should not be used as a sleep aid. “Alcohol on the whole is not useful for improving a whole night's sleep. Sleep may be deeper to start with, but then becomes disrupted. Additionally, that deeper sleep will probably promote snoring and poorer breathing. So, one shouldn't expect better sleep with alcohol."

The majority of studies, across different alcohol dosages, ages and genders, confirm an increase in slow-wave sleep (SWS) in the first half of the night. "SWS or deep sleep generally promotes rest and restoration," said Ebrahim. "However, when alcohol increases SWS, this may also increase vulnerability to certain sleep problems such as sleepwalking or sleep apnea in those who are predisposed.

"With increasing doses, alcohol suppresses our breathing. It can turn non-snorers into snorers and snorers into people with sleep apnea - where the breathing's interrupted", said Ebrahim.

Alcohol's affect on REM sleep is dramatic. REM sleep typically accounts for 20 to 25 percent of the night. Total night REM sleep percentage is halved in the majority of studies at moderate and high doses in so-called “normal” people as well as those with alcohol use disorders, such as the disease of alcoholism.

Dreams generally occur in the REM stage of sleep. During REM sleep the brain is more active, and may be regarded as “defragmenting the drive,” according to Ebrahim. REM sleep is also important because it can influence memory and serve restorative functions. Conversely, lack of REM sleep can have a detrimental effect on concentration, motor skills, and memory.

"One consequence of a delayed onset of REM sleep would be less restful sleep," he adds. "There is also a linkage with depression."
– from
The older archive article linked in the story's first paragraph takes you to a piece on lethargy and lack of alertness following a night when someone – alcoholic or non-alcoholic – has a nightcap or two or four before bed.
Sleep is a problem for those in recovery, a real struggle for the newly sober, and is often a trigger for a return to alcohol use. Getting a good night's sleep is essential, but isn't easy. Over-the-counter remedies are the last house on the block. (Most people in recovery avoid them like the plague.) Getting more, and better, sleep can be encouraged by:
Eliminating or greatly reducing caffeine intake, especially in the 4-6 hours before bedtime;
Getting aerobic exercise during the day, but not in the 4-6 hours before bedtime;
Eating foods that can help sleep such as tryptophan-rich nuts, seeds, honey, bananas. Warm milk sounds disgusting, but it works, too. And;
Abstaining from tobacco before bedtime (or completely). Nicotine is a stimulant, just like caffeine.