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Connection Between Alcohol and Sleep

Have you ever had a glass of wine before bed? Drinking alcohol causes feelings of relaxation and sleepiness, so naturally, some people turn to it as a sleep aid. But while alcohol may help you fall asleep, it does not provide you with the good night’s sleep you need. 

Consuming alcohol before bed actually leads to disrupted sleep. While you may fall asleep faster, your normal sleep pattern will be disrupted, leading to lower overall sleep quality.

Alcohol consumption, especially in excess, has been linked to a variety of sleep issues. Those with alcohol use disorder often report excessive daytime sleepiness, insomnia, and obstructive sleep apnea (OSA).

What is a Normal Sleep Cycle?

To understand how alcohol disrupts sleep, it’s essential to understand what a normal sleep cycle looks like. 

Sleep cycles involve four sleep stages: three non-rapid eye movement (NREM) stages and one rapid eye movement (REM) stage. 

The first three stages are known as NREM sleep, and the last is known as REM sleep.

During NREM sleep, muscles relax, heart rate drops, and brain activity slows. Your eyes move very little during this time. This is the first three of the four stages of your sleep cycle, and it makes up 75% of typical sleep activity. 

The most important stage within NREM sleep is stage three, known as slow-wave sleep. This is thought to be linked to creativity, insightful thinking, and memory. It is the stage where you experience the most restorative sleep.

During REM sleep, eye movement restarts and becomes very rapid and heart rate picks up. This is where dreaming occurs. 

While more mysterious than the other stages, scientists believe REM sleep is also important for memory consolidation. It represents the last 25% of your sleep cycle and typically lasts between 5 and 30 minutes.

These four sleep stages follow one another in 90 to 120-minute cycles (four to five cycles per every eight-hour sleep period). 

NREM sleep is more prevalent for the first two cycles, with REM sleep lasting no more than 10 minutes. 

During the second half of the night, REM sleep becomes more dominant, lasting up to 40 minutes, while NREM sleep ceases almost entirely. Young people typically experience the most REM sleep on average, with the typical duration decreasing with age.

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How Does Alcohol Ruin Sleep?

Consuming alcohol before bed interferes with normal sleep patterns by disrupting the sleep stages and the time spent in each stage. Since alcohol can help you fall asleep faster, you may skip the initial light sleep seen in stage one, entering a deep sleep and remaining in it longer than usual. 

This can create an imbalance between NREM and REM sleep, resulting in less REM sleep than usual. REM sleep is one of the most restorative stages of sleep, so this leads to lower quality sleep overall. 

Alcohol also increases the likelihood of waking during the second half of the night, where most REM sleep occurs. 

Drinking alcohol too close to bedtime can also ruin sleep by acting as a stimulant, delaying sleep onset. This mainly happens with light drinking right before bed.

As a result, sleep deprivation and feelings of excessive daytime sleepiness can occur. That can prompt some to use caffeine to stay awake the next day, which in turn leads to more alcohol consumption before bed. 

As tolerance builds up, this leads to a vicious cycle of growing sleep problems and increased risk for alcoholism. 

What Does Research Say About Alcohol and Sleep?

The research on alcohol’s effects on sleep is well established. One review of the data found that while alcohol initially promotes faster sleep onset, it ultimately leads to more sleep disruptions. This was even true for moderate alcohol consumption, with participants in one study showing reduced REM sleep.6

There are several ways this can happen, with one being through alcohol’s effects on body temperature. Multiple studies have found alcohol consumed 60 minutes before falling asleep decreases body temperature.4 

While sleeping, body temperature then rebounds, leading subjects to wake up in the middle of the night.4 This usually occurs during the second half of the night, which is dominated by REM sleep.

Another way alcohol can disrupt sleep is through movement disorders. In one study, people who consumed alcohol before bed had up to three times higher incidences of periodic leg movements at night (restless leg), causing them to wake up.1

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Can Just One Drink Affect Sleep? 

A 2018 study compared sleep quality among subjects based on the amount of alcohol consumed. It found that less than two servings of alcohol per day for men and just one for women reduced sleep quality by an average of 9.3%.3

Another study found that the risk for obstructive sleep apnea (OSA) increased in normal sleepers after just a single drink of alcohol.6

Just a single drink of alcohol can interfere with the production of an important hormone called melatonin. Melatonin helps us regulate our sleep cycles. According to one 2007 study, one drink of alcohol before bed decreases melatonin between 15% and 19%.5

Can Heavy Alcohol Use Lead to a Sleep Disorder?

Alcohol's effects on sleep grow with increased alcohol intake. For example, heavy drinkers are more likely to report poor sleep than light drinkers. A 2013 study found an association between frequent binge-drinking and insomnia.2 

According to the study, those who binge-drink more than two days a week have an 84% higher chance of developing insomnia symptoms than regular drinkers.2 It is likely that there is a vicious cycle between insomnia leading to more drinking and worsening sleep quality.

Another 2013 study found those who drink heavily experience higher rates of sleep issues. 

Women were 13% more likely to report difficulty both falling and staying asleep if they drink heavily. Men were 10% more likely to report difficulty falling asleep and 8% less likely to stay asleep if they engaged in heavy alcohol use.4

Alcohol and Obstructive Sleep Apnea (OSA)

One of the most common sleep-related conditions is obstructive sleep apnea (OSA), and is often seen in those who snore during sleep. 

OSA is a condition in which throat muscles intermittently relax and block the airway during sleep. Snoring is a notable symptom of OSA. Alcohol-induced OSA can increase a person’s risk of heart attack, stroke, and even death. It is most commonly associated with heavy drinkers but normal sleepers can develop it even after just one drink.

Alcohol appears to have a relationship with OSA that increases with the level of alcohol intake. According to a 2013 study, women who drink to excess more than twice a week have an 8% higher chance of developing OSA. For men who regularly binge drink, the chance of OSA goes up 10%.7

6 Tips for Sleeping Better After Drinking Alcohol

Here are six tips for better sleep after drinking alcohol:

  1. Use the bathroom before bed — Alcohol is a diuretic, which means it makes you produce more urine than usual. Be sure to use the bathroom before bed so your bladder does not wake you up later.
  2. Avoid caffeine -— Caffeine will, of course, make it more difficult to fall asleep. After the late afternoon, all caffeinated drinks should be avoided, especially if you plan to drink alcohol later.
  3. Allow your body time to process the alcohol — Drink no more than two standard drinks per hour to avoid becoming too intoxicated.
  4. Stick to your normal sleep schedule — It is easier to fall asleep if you do so at the same time each night on a regular basis. 
  5. Don’t drink carbonated beverages — Carbonated drinks are absorbed by your body easier. This makes you tipsy faster and, therefore, makes sleep more difficult.
  6. Control your drinking — Only drink one drink per hour and stop drinking four hours before bedtime.

Is Drinking to Fall Asleep a Sign of an Alcohol Problem? 

Among those suffering from alcohol use disorder (AUD), rates of sleep disturbances are higher than the general population.

One review of patients across six studies reported rates of insomnia ranging from 25% to 72% among alcoholics.6 Those with insomnia who drink alcohol to help themselves fall asleep faster are more likely to have problems with alcohol use. 

Disturbed sleep is also an alcohol withdrawal symptom, with some aspects including delayed sleep onset. And because alcohol ultimately perpetuates sleep disturbance through reduced REM sleep, those who use it are more at risk for AUD.

Resources

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Bibliography

Aldrich, MS, and JE Shipley. “ Alcohol use and periodic limb movements of sleep.” Alcohol Clin Exp Res, vol. 17, no. 1, 1993, pp. 192-6. pubmed.ncbi.nlm.nih.gov.

American Academy of Sleep Medicine. “ Frequent binge drinking is associated with insomnia symptoms in older adults.” aasm.org, 2013.

Pietilä, Julia, et al. “ Acute Effect of Alcohol Intake on Cardiovascular Autonomic Regulation During the First Hours of Sleep in a Large Real-World Sample of Finnish Employees: Observational Study.” JMIR mental health, vol. 5, no. 1, 2018. pubmed.ncbi.nlm.nih.gov.

Roehrs, Timothy, and Thomas Roth. “ Sleep, Sleepiness, and Alcohol Use.” Alcohol Res Health, vol. 25, no. 2, 2001, pp. 101-9. NCBI.

Rupp, Tracy L., et al. “ Evening alcohol suppresses salivary melatonin in young adults.” Chronobiology international, vol. 24, no. 3, 2007, pp. 463-470. pubmed.ncbi.nlm.nih.gov.

Stein, Michael D., and Peter D. Friedmann. “Disturbed Sleep and Its Relationship to Alcohol Use.” Substance abuse, vol. 26, no. 1, 2005, pp. 1-13. NCBI.

Popovici, Ioana, and French, Michael T., “ Binge Drinking and Sleep Problems Among Young Adults.” Drug and alcohol dependence, vol. 132, 2013, pp. 207-15. NCBI

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