Olivia Kibaba
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October 20, 2022

How Are Sleep Disorders & Addiction Connected?

Sleep disorders and addiction share a complex and bidirectional relationship. People who suffer from a sleep disorder may be more likely to abuse drugs or alcohol to try and self-medicate and achieve better sleep. For instance, they may use stimulant drugs to compensate for daytime fatigue caused by lost sleep.

In other cases, they may use drugs because of issues like cognitive impairment. Conversely, people addicted to drugs or alcohol may also suffer from sleep disorders due to the negative effects these substances can have on the body and mind.

There is a strong link between sleep disorders and addiction. A review by the Addiction Science & Clinical Practice found that about 70 % of patients admitted for detox had sleep issues before admission, and 80 % of those with sleep problems connect them to alcohol or illegal drug use.

According to the review, the relationship between the two seems to be bidirectional, with chronic or acute substance use disorders increasing the risk of developing sleeping problems. The review also adds that there's evidence indicating that long-term abstinence from chronic drug or alcohol use can reverse some sleep problems. 

One of the most common ailments related to lack of sleep is depression. If you’re wondering whether or not you or someone you know suffers from depression, one way to learn more is to take a depression test. 

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How substance abuse leads to sleep disorders

Addiction is a brain disease. Chronic alcohol or drug use interferes with the brain, changing its chemistry and circuitry. These changes result in compulsive drug use and sleeping problems. Drug and alcohol use disorders can cause short- and long-term sleep issues like insomnia and sleep apnea. 

Substance abuse also alters how a person through their sleep stages - messing up the rapid and non-rapid eye movement (REM and NREM). Generally, substance abuse can lead to:

  • Lower overall sleep time
  • Less "good" sleep
  • Strong daytime sleepiness (hypersomnia)
  • Nighttime wakefulness

Here is a quick look at how different drugs affect sleep.

Marijuana  

Marijuana interacts with the endocannabinoid system (ECS) by binding to the cannabinoid receptors responsible for many roles, including regulating the sleep-wake cycle. This explains why more than 40% of those trying to quit marijuana experience sleeping problems. Many others experience sleep difficulty, strange dreams, and nightmares too. 

Opioids 

Opioids like heroin bind to mu-opioid receptors, a body system that’s also responsible for sleep regulation. In fact, the name morphine or morphia, a medical derivative of opium, comes from Morpheus, the Greek god of sleep and dreams. Opioid drugs can induce sleepiness but also derange sleep by increasing transitions between different sleep stages.

Those going through withdrawal from heroin addiction can experience terrible insomnia. Opioids can also regulate respiration and, when taken in high doses, can severely impede breathing during sleep. 

Depressants

Depressants like alcohol may help people fall asleep, but they often lead to disruptions in sleep patterns and can make it difficult to stay asleep. Chronic alcohol use causes:

  • Overall decrease in sleep time
  • Prolonged sleep latency
  • Decreased REM sleep
  • Decreased sleep efficiency
  • Early morning awakenings
  • Difficulty maintaining sleep
  • Nonrestorative sleep and fatigue

 

Cocaine and other stimulants

Stimulants like cocaine can make it difficult to fall asleep and cause people to wake up frequently at night. The sleep disturbances like insomnia and hypersomnolence mostly happen during cocaine intoxication and withdrawal. Other stimulants like amphetamine trigger dopamine release.

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During acute administration, they can decrease total sleep time and sleep efficiency and increase sleep latency and the number of awakenings. In the withdrawal phase, there's a drop in sleep latency and a rise in total sleep time and efficiency.

Drug withdrawal and sleep disorders

Withdrawal from drugs can cause sleep disorders like insomnia, or other sleep problems, including restless legs syndrome, strange dreams, or broken sleep. These issues can take a toll on one’s physical and mental health, making a recovery harder. Sleep problems are common when withdrawing from:

How sleep disorders lead to substance abuse

Sleep disorders can also lead to substance abuse. Many people with sleep disorders turn to substances as a way to self-medicate or try and improve their sleep. For example:

  • People with chronic insomnia may start drinking alcohol to fall asleep, or they may take prescription medications to fall asleep. Without these drugs, they may end up not getting a good night’s rest and may use substances like caffeine or nicotine to stay awake during the day.
  • People with obstructive sleep apnea often experience periods of interrupted breathing during sleep, leading to sleep deprivation. This can cause them to feel tired during the day, leading them to abuse drugs or alcohol to get some relief.
  • Restless leg syndrome is a condition that causes an uncontrollable urge to move the legs, often accompanied by a feeling of pins and needles. This can make falling and staying asleep difficult, leading people to turn to drugs or alcohol to relax their muscles and drift off.

 

The dangerous cycle

As discussed earlier, people with sleep may take stimulants like caffeine, cocaine, or nicotine to stay awake during the day and then use alcohol or other drugs to fall asleep at night. Also, those struggling with addiction may disrupt their circadian system and end up with sleep disorders that lead them to use more substances to self-medicated. This can create a dangerous cycle in which they use substances to try and manage their sleep, but the substances themselves make it difficult for them to get the rest they need.

Sleep quality and addiction recovery

People who stop using drugs and alcohol often have better sleep. This happens because they are no longer disturbed by the side effects of those substances. When people get good sleep, they feel better and can concentrate more easily on their addiction recovery.

At the same time, people who sleep better don't need to use substances to cope with their fatigue. So, improving sleep can help break the cycle of addiction.

If you or a family member or someone you know is struggling with a sleep disorder and substance abuse, help is available. There are many treatment options that can address both issues at the same time. With treatment, it is possible to recover from both a sleep disorder and addiction.

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