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The drink you want to avoid before bed

Alcohol has been credited with a number of good and bad effects but everyone agrees that abstinence is best and moderation is better. With regards to insomnia, alcohol has no benefits. While it may improve sleep for a few days, it can cause lasting damage to sleep quality and sleep structure. Alcoholism is also the bridge between insomnia and most psychological conditions. And recovering alcoholics who suffer from severe insomnia are most likely to relapse. Because it can be habit-forming, alcohol is the one drink you want to avoid before bed. It is the worst sleep aid you can use. Read on to find out why and how alcohol is bad for your health and sleep.
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The Effects of Alcohol on Health

Alcohol consumption affects the body in multiple ways. While there are a few benefits to light drinking (a little alcohol has been linked to higher HDL cholesterol levels), there are more harmful effects of alcohol.

The major short-term effects of alcohol consumption are dehydration and intoxication.

Alcohol causes dehydration by inhibiting the production of vasopressin, an anti-diuretic hormone, and also by blocking the release of this hormone from the pituitary gland. Instead, alcohol encourages the body to eliminate water through urine (and vomit).

Long-term effects of alcohol usually involve damage to the liver and central nervous system. Because the body can quickly develop dependence to alcohol, long-term imbibers mostly suffer from alcoholism.

In the central nervous system, alcohol affects the release of neurotransmitters. Therefore, it disrupts the balance of these brain chemicals. For example, studies show that alcohol stimulates the release of adrenaline but blocks serotonin.

In the pancreas, alcohol stimulates increased release of insulin. Therefore, it speeds up the utilization of glucose and can cause hypoglycemia. In diabetics, the low blood sugar level triggered by alcohol consumption may be fatal.

Alcohol and Insomnia

Alcohol has the welcome effect of knocking people unconscious. For this reason, many use it as a sleep aid in the treatment of insomnia. How well does alcohol promote sleep and how well can it serve as a ready sleep aid?

The Dual Nature of Alcohol

Paradoxically, alcohol has both stimulatory and depressive effects on the body. On one hand, it releases stimulatory neurotransmitters in the brain. On the other hand, it dulls the senses. Alcohol is also a muscle relaxant.

The dual nature of alcohol is the chief reason why some believe that alcohol makes them tranquil, relaxed and sleepy while others believe that it makes them more aggressive and aroused.

In most cases, scientists have demonstrated that most people do have different expectations about alcohol and act towards that.

However, alcohol addiction is real and so is the fitful sleep, drowsiness and disinhibition it causes. The morning-after hangover is definitely real too.

Using Alcohol as a Sleep Aid

Studies show that a good number of people use alcohol to improve their insomnia. In most cases, alcohol fails as a sleep aid after a short while.

This is because the body quickly develops tolerance to some of the effects of alcohol.

Therefore, alcohol may help you sleep at night when you first try it but its sedative effect is lost after a few days.

To try and regain its sleep-inducing effect, many increase their consumption of alcohol and end up becoming addicted to it.

Sleep induced by alcohol is rarely refreshing. It usually ends with the drinker waking up jarringly in the middle of the night and then unable to go back to sleep. Once tolerance sets in, alcohol can even make it difficult to sleep and impossible to stay asleep.

This is because even when the sedative effects of alcohol is lost, its negative effects on the body still goes on.

There are different ways in which alcohol consumption before bed can stop you from getting a good night’s rest. For example, alcohol dehydrates the body even while promoting water loss through diuresis.

As alcohol presses the body to get rid of water through the urine, the urgent need to urinate means that drinkers need to wake up frequently during the night. Unfortunately, once awake, it becomes increasingly difficult to go back to sleep because the sedative effect of alcohol is already gone as the body metabolizes alcohol.

Alcohol, Depression and Insomnia

Multiple studies have demonstrated that there is a thread linking depression, insomnia and alcohol consumption.

These studies show that both men and women who experience depression are likely to consume alcohol. This compounds their sleeplessness. Since insomnia is already one of the presentations of depression, alcohol consumption can only worsen it.

In addition, taking alcohol with antidepressants can lead to accelerated liver damage.

It is really difficult to determine which of the 3 conditions (insomnia, depression and alcoholism) starts this cycle but it is clear that they feed on one another.

Depression shares some root causes with insomnia. Both conditions involve neurotransmitter imbalance in the brain. These neurotransmitters include serotonin, dopamine and GABA (gamma aminobutyric acid) as well as the neurohormone, melatonin.

Unfortunately, these brain chemicals are also affected by alcohol consumption.

Therefore, a depressed person may take to alcohol to help himself sleep better or feel better. However, the first relief is never sustained and soon higher levels of alcohol are needed to recreate the earlier buzz or calm.

More than anyone, people experiencing depression should never use alcohol as sleep aid.

Alcohol, Sleep Apnea and Insomnia

Sleep apnea is a breathing disorder during sleep that involves the narrowing of the upper airways. The closing of the air passage awakens the sleeper because it interrupts breathing.

When arousal causes breathing to resume, the sleeper may resume sleep without really fully waking up.

However, sleep apnea interrupts sleep a lot during the night. This means that the sleeper never fully reaches slow wave or “deep” sleep because of the constant interruptions. Because deep sleep is the restful stage of sleep, sleep apnea not only reduces the duration of sleep but also its quality.

Unfortunately, alcoholism is one of the leading causes of sleep apnea.

Therefore, regular binging can disrupt sleep by affecting breathing. This worsens hangover in the morning and certainly promotes daytime sleepiness.

Alcohol causes sleep apnea because it is also a muscle relaxant. When it relaxes the muscles at the back of the throat responsible for keeping the air passage open, the passage closes and interrupts breathing.

Studies have shown that even moderate doses of alcohol consumed before bedtime can increase the risk of obstructive sleep apnea. Alcohol consumption before bedtime can also cause the narrowing of the airways even in people who do not suffer from OSA (obstructive sleep apnea).

These studies also found that the combination of alcohol and sleep apnea severely impacts mental and motor skills during the day and is associated with increased risks of heart disease, stroke, sudden death and traffic accidents.

How Alcohol Affects Sleep Pattern

When consumed before bedtime, alcohol first produces a stimulating effect. Thereafter, it may promote sleepiness and reduce the time taken to fall asleep but it totally ruins the sleep cycle and then rouses the drinker soon after.

Researchers show that consuming alcohol within 6 hours before bedtime can disrupt sleep structure.

Both the diuretic effect of alcohol as well as its clearance from the body during the night cause repeated arousal and sleep fragmentation.

Therefore, alcohol decreases REM (rapid-eye movement, the first stage of sleep and the least restful) sleep as well as deep sleep. When REM is cut short, it reappears (REM rebound) later in the night when deep sleep should predominate.

Rebounding REM disrupts deep sleep (and makes sleep unrefreshing), leads to fragmented dreaming and can cause nightmares too.

Alcohol disrupts sleep architecture by disrupting the regular release of sleep-promoting hormones and neurotransmitters such as melatonin and serotonin. Therefore, it affects the sleep-wake cycle and may push sleep far into daytime.

The effect of alcohol on sleep pattern may be long-lasting too. For example, insomnia is one of the symptoms of alcohol withdrawal syndrome.

In addition, sleep patterns may never be normal again even after years of abstaining from alcohol.

Studies show that former alcoholics sleep poorly and experience reduced deep sleep. When they take up drinking again, they sleep better for some days and are tempted to fully relapsed. However, any improvement in sleep is soon lost.   

Studies on Alcohol and Insomnia

Does Alcohol Consumption Disturb Sleep?

A 2006 review published in the journal, Substance Abuse, reviewed some of the past studies that have investigated the link between alcohol consumption and insomnia. The researchers gathered data from 107 well-designed studies conducted between 1966 and 2002.

They found that these studies provided clinical evidence to suggest that alcohol consumption disrupted sleep.

Specifically, the researchers highlighted behavioral studies that showed that consuming 2 – 3 drinks before going to bed promoted sleep initially but the sedative effect of alcohol was lost after only 3 days of using it as a sleep aid.

In conclusion, the researchers argued that the alcohol consumption patterns of insomnia patients should be closely investigated in the treatment of sleep problems.

The most recent study to link alcohol consumption with insomnia was published in the journal, American Academy of Sleep Medicine in 2013.

This study investigated the effects of binge drinking on insomnia in older adults.

The study took data from almost 5,000 adults aged 55 and above from the 2004 edition of the Health and Retirement Study.

The results of this study showed that 26% of the participants had 2 or less binge drinking days per week while 3% had more than 2 binge drinking days per week.

The results of the study showed that

  • occasional binge drinking (1 binge drinking day per week) had little effect on insomnia
  • frequent binge drinking (more than 2 binge drinking days per week) carries 84% more risk of insomnia

This study found that binge drinking made it difficult to fall asleep and stay asleep. It also caused drinkers to wake up too early and to feel unrested in the morning.

The researchers, therefore, concluded that given the strong association between alcohol consumption and insomnia, abstaining from alcohol should be used as one of the main interventions for treating insomnia.

Insomnia and Relapse into Alcoholism

While abstaining from alcohol can help alcoholics get better sleep, the improvement is not instantaneous.

In the time taken for recovering alcoholics to get better, the risk of relapse is high because of the worsening insomnia.

A 2001 study published in The American Journal of Psychiatry highlights this problem. In that study, the researchers asked 172 adults receiving treatment for alcohol dependence to fill sleep questionnaires, rate their depression and alcohol problems as well as take a polysomnogram while abstaining from alcohol.

The results of the study showed that

  • patients with insomnia had more severe alcohol dependence, more severe depression and worse polysomnogram (measures sleep quality and pattern) scores
  • patients with insomnia were twice as likely to relapse and take up drinking again compared to those without insomnia

This study shows that insomnia is both a cause of alcohol dependence as well as a good predictor of the failure of alcohol withdrawal treatments.

Therefore, there is a higher likelihood of returning to alcoholism among recovering alcoholics who suffer from insomnia than those who sleep better. The severity of insomnia is one of the best ways to determine which recovering alcoholics need more help staying away from alcoholic drinks.

These results were echoed again in a 2003 paper published in the journal, Sleep Medicine Reviews.

Such studies have led researchers to believe that relieving insomnia should be one of the treatment goals of alcohol dependence treatments.





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