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May 9, 2019

How Sleep Affects Recovery

Addiction has devastating effects on all areas of one’s life—including sleep.  People suffering from addiction are approximately 5- 10 times more likely to develop sleep disorders. Ironically, many people initially use drugs and alcohol to help them with sleep issues, but end up getting addicted to the very substances they used to help them alleviate their sleep problems.  For example, alcohol, a depressant, is used by nearly 30 percent of Americans as a vehicle to help induce sleep, and although it helps in that regard, the sleep derived from alcohol consumption is very disruptive and can easily lead to nightmares, sleep apnea, and snoring. It wreaks havoc on core body temperature, one of the most important mechanisms involved in regulating sleep.

Stimulants like cocaine, hallucinogens, and amphetamines activate the brain by flooding it with dopamine, energizing the user and making it extremely difficult to sleep. Opiates like hydrocodone, oxycodone, and methadone induce euphoria—similar to stimulants—which causes the users’ REM sleep cycle to be cut in half. As a result, they suffer from light, less refreshing sleep. Sleep disorders triggered by addiction are known as “substance-induced sleep disorders,” and include:

  • Insomnia – a common sleep disorder in which one has difficulty either falling asleep or staying asleep. People suffering from insomnia may constantly toss and turn, waking many times during the night or too early in the morning.
  • Hypersomnia – is characterized by excessive sleepiness during daytime hours which is usually due to insomnia and a lack of feeling refreshed from a good night’s sleep. Sufferers often nod off during the day, and display sluggish energy when engaging in required tasks.
  • Parasomnias – is a condition which encompasses abnormal sleep behaviors like sleepwalking or violent nightmares. This condition is common in people who abuse hallucinogens.
  • Sleep apnea– is a sleep disorder involving difficulty breathing. Sufferers often momentarily stop breathing while asleep. This can happen multiple times each night, creating a greatly reduced sleep quality and potentially fatal complications.

Sleep problems are inextricably linked to the recovery process. For example, detox is an exceptionally difficult recovery stage as the body transitions through debilitating physical withdrawal symptoms like tremors, vomiting, delirium, and headaches, as well as psychological symptoms like depression, anxiety, and irritability. This battery of symptoms leads to further sleep deprivation and insomnia—one of the most common and persistent challenges in the entire withdrawal process.

As the brain begins to re-adjust to normal dopamine levels, stress, anxiety, and physical pain become much harder to cope with and insomnia is intensified. Unfortunately, insomnia frequently leads to relapse, and the risk is doubled for those who have developed drug-induced sleep disorders. Therefore, treating these disorders is an important part of any treatment plan.  There are several recommendations that should be followed to ensure better sleep quality during recovery.

  • Create a regular bedtime sleep/wakeup schedule and don’t deviate—even on weekends. This helps circadian rhythms adjust to a regular pattern and trains your mind to tire and wake up the same time each day. Avoid taking naps during the day, especially in the afternoons.
  • Use the bedroom only for sleep or intimacy. Avoid reading, working on the computer, watching TV, or doing other activities not associated with sleeping.  Make sure the bedroom is free from clutter and promotes a restful environment.
  • Soothing bedtime rituals such as a taking a warm bath, practicing gentle yoga or meditation, or playing soft music help people in recovery smoothly transition from the intensity of daytime activities to the peaceful mindset required for sleep.
  • Avoid caffeine, nicotine, and eating heavy meals right before bedtime. Avoid sugar, spicy foods, and chocolate—which inhibit sleep—after the middle of the day. Eat sleep promoting foods such as dairy products, leafy green vegetables, and legumes instead.
  • Commit to an exercise routine early in the day, for example, walking, running, or swimming. This helps release excess energy and accumulated stress, ensuring that the body is tired at the end of the day.
  • Make sure that you have a comfortable mattress on which to sleep. A good bed is one of life’s greatest investments!  Keeping your bedroom completely dark with black out curtains or shades, and at a cool, comfortable temperature (70 degrees or below) is also vital. Blue light emitting from electronic devices such as ipads, cell phones, and alarm clocks is notorious for interfering with sleep by disrupting melatonin production.  Remove these devices from the bedroom and make sure your alarm clock is not close to your head. 

 

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